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01-11-2017 | Original Article

The surgical outcomes of lung cancer combined with interstitial pneumonia: a single-institution report

Authors: Daisuke Taniguchi, Naoya Yamasaki, Takuro Miyazaki, Tomoshi Tsuchiya, Keitaro Matsumoto, Go Hatachi, Tomoyuki Kakugawa, Noriho Sakamoto, Hiroshi Mukae, Takeshi Nagayasu

Published in: Surgery Today | Issue 11/2017

Abstract

Purpose

Several studies have reported that an acute exacerbation (AE) of idiopathic interstitial pneumonia (IIP) can occur after lung resection in patients with non-small cell lung cancer (NSCLC); however, the perioperative management strategy is controversial.

Methods

The data of lung cancer patients at Nagasaki University Hospital from June 1994 to October 2013 were retrospectively reviewed.

Results

Among all 1701 NSCLC patients who underwent lung resection, 59 (3.5%) had IIP. Five patients (8.5%) had an AE of IIP following lung resection, three (60%) of whom died in hospital. Univariate and multivariate analyses were performed to identify possible risk factors for AE. The univariate analyses identified LDH and the volume of blood loss as risk factors. The multivariate analysis identified no factors. The treatment for an AE included steroid pulse therapy and neutrophil elastase inhibitor therapy. Direct hemoperfusion with polymyxin B immobilized the fiber column and immunosuppressant therapy was attempted in some of the patients who did not respond to these treatments.

Conclusion

Patients with lung cancer and IIP have a higher risk of chest surgery and a poor prognosis. Very careful surgery and perioperative management are needed, because AEs are often difficult to AE predict.

Harris JM, Johnston ID, Rudd R, Taylor AJ, Cullinian P. Cryptogenic fibrosing alveolitis and lung cancer: the BTS study. Thorax. 2010;65:70–6.CrossRefPubMed

Matsushita H, Tanaka S, Sakai Y, Hara M, Nakata K, Tanimura S, et al. Lung cancer associated with usual interstitial pneumonia. Pathol Int. 1995;45:925–32.CrossRefPubMed

Isobe K, Takenaka K, Sakamoto S, Takai Y, Shibuya K, Homma S. Clinical characteristics of acute respiratory deterioration in pulmonary fibrosis associated with lung cancer following anti-cancer therapy. Respirology. 2010;15:88–92.CrossRefPubMed

Minegishi Y, Takenaka K, Mizutani H, Sudou J, Noro R, Okano T, et al. Exacerbation of idiopathic interstitial pneumonias associated with lung cancer therapy. Intern Med. 2009;48:665–72.CrossRefPubMed

Kumar P, Goldstraw P, Yamada K, Nicholson AG, Wells AU, Hansell DM, et al. Pulmonary fibrosis and lung cancer: risk and benefit analysis of pulmonary resection. J Thorac Cardiovasc Surg. 2003;125:1321–7.CrossRefPubMed

Koizumi K, Hirata T, Hirai K, Mikami I, Okada D, Yamagishi S, et al. Surgical treatment of lung cancer combined with interstitial pneumonia: the effect of surgical approach on postoperative acute exacerbation. Ann Thorac Cardiovasc Surg. 2004;10:340–6.PubMed

Watanabe A, Kawaharada N, Higami T. Postoperative acute exacerbation of IPF after lung resection for primary lung cancer. Pulm Med. 2011;2011:960316.CrossRefPubMedPubMedCentral

Chiyo M, Sekine Y, Iwata T, Tatsumi K, Yasufuku K, Iyoda A, et al. Impact of interstitial lung disease on surgical morbidity and mortality for lung cancer: analysis of short-term and long-term outcomes. J Thorac Cardiovasc Surg. 2003;126:1141–6.CrossRefPubMed

Chida M, Kobayashi S, Karube Y, Hayama M, Tamura M, Ishihama H, et al. Incidence of acute exacerbation of interstitial pneumonia in operated lung cancer: institutional report and review. Ann Thorac Cardiovasc Surg. 2012;18:314–7.CrossRefPubMed

10.

Sakamoto S, Homma S, Mun M, Fujii T, Kurosaki A, Yoshimura K. Acute exacerbation of idiopathic interstitial pneumonia following lung surgery in 3 of 68 consecutive patients: a retrospective study. Intern Med. 2011;50:77–85.CrossRefPubMed

11.

Iyoda A, Jiang S, Amano H, Ogawa F, Matui Y, Kurouzu N, et al. Prediction of postoperative exacerbation of interstitial pneumonia in patients with lung cancer and interstitial lung disease. Exp Ther Med. 2011;2:1073–6.CrossRefPubMedPubMedCentral

12.

Sato T, Teramukai S, Kondo H, Watanabe A, Ebina M, Kishi K, et al. Impact of acute exacerbation of interstitial lung diseases after pulmonary resection for lung cancer. J Thorac Cardiovasc Surg. 2014;147:1604–11.CrossRefPubMed

13.

The Japanese Respiratory Society. Idiopathic interstitial pneumonias: diagnosis and treatment. 2nd ed. Tokyo: Nankodo; 2011.

14.

Raghu G, Collard HR, Egan JJ, Martinez FJ, Behr J, Brown KK, et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med. 2011;183:788–824.CrossRefPubMedPubMedCentral

15.

Collard HR, Moore BB, Flaherty KR, Brown KK, Kaner RJ, King TE Jr, Lasky JA, et al. Acute exacerbations of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2007;176:636–43.CrossRefPubMedPubMedCentral

16.

Sato T, Kondo H, Watanabe A, Nakajima J, Niwa H, Horio H, et al. A simple risk scoring system for predicting acute exacerbation of interstitial pneumonia after pulmonary resection in lung cancer patients. Gen Thorac Cardiovasc Surg. 2015;63:164–72.CrossRefPubMed

17.

Kawasaki H, Nagai K, Yokose T, Yoshida J, Nishimura M, Takahashi K, et al. Clinicopathological characteristics of surgically resected lung cancer associated with idiopathic pulmonary fibrosis. J Surg Oncol. 2001;76:53–7.CrossRefPubMed

18.

Park J, Kim DS, Shim TS, Lim CM, Koh Y, Lee SD, et al. Lung cancer in patients with idiopathic pulmonary fibrosis. Eur Respir J. 2001;17:1216–9.CrossRefPubMed

19.

Maeda H, Kanzaki M, Sakamoto K, Isaka T, Oyama K, Murasugi M, et al. Effect of collagen vascular disease-associated interstitial lung disease on the outcomes of lung cancer surgery. Surg Today. 2017. doi:10.1007/s00595-017-1476-z.PubMedCentral

20.

Tanita T, Chida M, Hoshikawa Y, Handa M, Sato M, Sagawa M, et al. Experience with fatal interstitial pneumonia after operation for lung cancer. J Cardiovasc Surg (Torino). 2001;42:125–9.

21.

Masuda M, Okumura M, Doki Y, Endo S, Hirata Y, Kobayashi J, et al. Thoracic and cardiovascular surgery in Japan during 2014: annual report by the Japanese Association for Thoracic Surgery. Gen Thoracic Surg. 2016;64:665–97.CrossRef

22.

Soares Pires F, Caetano Mota P, Melo N, Costa D, Jesus JM, Cunha R, et al. Idiopathic pulmonary fibrosis—clinical presentation, outcome and baseline prognostic factors in a Portuguese cohort. Rev Port Pneumol. 2013;19:19–27.CrossRefPubMed

23.

Katayama H, Kurokawa Y, Nakamura K, Ito H, Kanemitsu Y, Masuda N, et al. Extended Clavien-Dindo classification of surgical complications: Japan Clinical Oncology Group post-operative complications criteria. Surg Today. 2016;46:668–85.CrossRefPubMed

24.

Shintani Y, Ohta M, Iwasaki T, Ikeda N, Tomita E, Kawahara K, et al. Predictive factors for postoperative acute exacerbation of interstitial pneumonia combined with lung cancer. Gen Thorac Cardiovasc Surg. 2010;58:182–5.CrossRefPubMed

25.

Kutlu CA, Williams EA, Evans TW, Pastorino U, Goldstraw P. Acute lung injury and acute respiratory distress syndrome after pulmonary resection. Ann Thorac Surg. 2000;69:376–80.CrossRefPubMed

26.

Goto T, Maeshima A, Akanabe K, Oyamada Y, Kato R. Acute exacerbation of idiopathic pulmonary fibrosis of microscopic usual interstitial pneumonia pattern after lung cancer surgery. Ann Thorac Cardiovasc Surg. 2011;17:573–6.CrossRefPubMed

27.

Sato T, Watanabe A, Kondo H, Kanzaki M, Okubo K, Yokoi K, et al. Long-term results and predictors of survival after surgical resection of patients with lung cancer and interstitial lung disease. J Thorac Cardiovasc Surg. 2015;149:64–70.CrossRefPubMed

28.

Muraoka M, Akamine S, Tsuchiya S, Kamohara R, Morino S, Mochinaga H, et al. The efficacy of perioperative administration of steroid and erythromycin in the surgery for lung cancer complicated with interstitial pneumonia. Kyobu Geka. 2007;60:871–8 (abstract in English).PubMed

29.

Iwata T, Yoshida S, Nagato K, Nakajima T, Suzuki H, Tagawa T, et al. Experience with perioperative pirfenidone for lung cancer surgery in patients with idiopathic pulmonary fibrosis. Surg Today. 2015;45(10):1263–70.CrossRefPubMed

30.

Ito H, Nakayama H, Yokose T, Yamada K. Prophylaxis for acute exacerbation of interstitial pneumonia after lung resection. Asian Cardiovasc Thorac Ann. 2014;22(8):948–54.CrossRefPubMed

31.

Iwata K, Doi A, Ohji G, Oka H, Oba Y, Takimoto K, et al. Effect of neutrophil elastase inhibitor (sivelestat sodium) in the treatment of acute lung injury(ALI) and acute respiratory distress syndrome(ARDS): a systematic review and meta-analysis. Intern Med. 2010;49:2423–32.CrossRefPubMed

32.

Abe S, Azuma A, Mukae H, Ogura T, Taniguchi H, Bando M, et al. Polymixin B-immobilized fiber column (PMX) treatment for idiopathic pulmonary fibrosis with acute exacerbation: a multicenter retrospective analysis. Intern Med. 2012;51:1487–91.CrossRefPubMed

33.

Watanabe T, Hoshikawa Y, Ishibashi N, Suzuki H, Notsuda H, Watanabe Y, et al. Mesenchymal stem cells attenuate ischemia-reperfusion injury after prolonged cold ischemia in a mouse model of lung transplantation: a preliminary study. Surg Today. 2017;47:425–31.CrossRefPubMed

34.

Islam MN, Das SR, Emin MT, Wei M, Sun L, Westphalen K, et al. Mitochondrial transfer from bone-marrow-derived stromal cells to pulmonary alveoli protects against acute lung injury. Nat Med. 2012;17:939–46.

Title: The surgical outcomes of lung cancer combined with interstitial pneumonia: a single-institution report
Authors: Daisuke Taniguchi
Naoya Yamasaki
Takuro Miyazaki
Tomoshi Tsuchiya
Keitaro Matsumoto
Go Hatachi
Tomoyuki Kakugawa
Noriho Sakamoto
Hiroshi Mukae
Takeshi Nagayasu
Publication date: 01-11-2017
Publisher: Springer Japan
Published in: Surgery Today / Issue 11/2017
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-017-1551-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The surgical outcomes of lung cancer combined with interstitial pneumonia: a single-institution report

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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