Clinical features of lung cancer in smokers with light and mild chronic obstructive pulmonary disease: a retrospective analysis of Japanese surgical cases

Yoshida, Kazuo; Eguchi, Takashi; Kobayashi, N.; Saito, Gaku; Hamanaka, Kazutoshi; Shiina, Takayuki; Kurai, Makoto

doi:10.1016/j.ejcts.2011.03.017

Cited by 15 publications

(45 citation statements)

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“…After initial screening based on titles and abstracts with predefined inclusion/exclusion criteria, 58 articles were identified for full-text review, of which 26 articles were identified for metaanalysis. 3,5,[13][14][15][16][17][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] Of these, 19 specifically reported the results on COPD, 3,5,13,14,16,20,[22][23][24]27,29,30,32-38 5 on emphysema, 17,21,26,28,31 and 2 on both COPD and emphysema 15,25 with lung cancer prognosis. Table 1 presents the characteristics of 21 studies for concomitant COPD and lung cancer survival.…”

Section: Discussionmentioning

confidence: 99%

Impact of COPD and emphysema on survival of patients with lung cancer: A meta‐analysis of observational studies

et al. 2015

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Both COPD and emphysema are associated with an increased incidence of lung cancer, but the impacts of these comorbidities on lung cancer prognosis are still unclear. Herein, we conducted a meta-analysis to clarify whether the presence of these comorbidities indicates poor survival in patients with lung cancer. A comprehensive search was conducted using PubMed, Embase, Web of Science, ASCO Abstracts and Cochrane library for articles published before 1 June 2015. Papers referenced by the obtained articles were also reviewed. Main outcomes were overall survival (OS) and disease-free survival (DFS) in patients with lung cancer. Pooled hazard ratio (HR) and 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup and sensitivity analyses were also conducted. Of 58 full texts reviewed, 26 met our inclusion criteria that were derived from 21 and seven studies examining the impacts of COPD and emphysema on survival of lung cancer, respectively. Metaanalyses revealed that concomitant COPD was associated with poorer OS (HR, 1.17; 95% CI: 1.10-1.25, n = 20), which was independent of tumour staging, diagnostic criteria of COPD or location, and DFS (HR, 1.52; 95% CI: 1.04-2.23, n = 6) with high heterogeneity (I 2 = 78%). The presence of emphysema in patients with lung cancer predicted worse OS (HR, 1.66; 95% CI: 1.25-2.22, n = 7), but not poorer DFS. The presence of COPD and emphysema are robust predictors of poor survival in patients with lung cancer. Early detection of these diseases should be taken into account for lung cancer surveillance and management.

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Section: Discussionmentioning

confidence: 99%

Impact of COPD and emphysema on survival of patients with lung cancer: A meta‐analysis of observational studies

et al. 2015

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“…The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines recommend that spirometry should be performed after administration of a short‐acting inhaled bronchodilator to minimize variability such as asthma; however most medical records documented that spirometry had been performed without an inhaled bronchodilator in a practice setting. Patients with a smoking history and a ratio of forced expiratory volume in one second (FEV1) to forced vital capacity of less than 70% were classified as COPD patients . GOLD spirometry grades were used to classify the severity of airflow limitation: GOLD 1 (mild), FEV1 ≥ 80% predicted; GOLD 2 (moderate), 50% ≤ FEV1 < 80% predicted; GOLD 3 (severe), 30% ≤ FEV1 < 50% predicted; and GOLD 4 (very severe), FEV1 < 30% predicted .…”

Section: Methodsmentioning

confidence: 99%

Survival significance of coexisting chronic obstructive pulmonary disease in patients with early lung cancer after curative surgery

et al. 2017

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BackgroundThe impact of chronic obstructive pulmonary disease (COPD) severity on survival after curative resection of early‐stage lung cancer (NSCLC) has not been sufficiently elucidated.MethodsWe retrospectively reviewed 250 consecutive patients who underwent lobectomy with lymph nodal dissection for pathological stage I–II NSCLC.ResultsAmong the COPD patients, 28 were classified as Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1, 21 as GOLD 2, and one as GOLD 3. The cumulative overall survival (OS) of the non‐COPD, GOLD 1, and GOLD 2–3 groups at five years was 90.7%, 85.7%, and 55.3%, respectively, (P < 0.0001), while recurrence‐free survival (RFS) between the groups at five years was 84.7%, 80.7%, and 72.9%, respectively. Although RFS in the GOLD 2–3 group tended to indicate a poor prognosis, there was no statistical difference between the groups (P = 0.385). In multivariate analysis, age ≥75 years, pN1, and GOLD 2–3 COPD were independent factors for a poor prognosis (P = 0.034, P = 0.010, and P = 0.030, respectively).ConclusionsOur results indicate that early stage NSCLC patients with COPD had a significantly increased risk of poorer OS and potentially an increased risk of poor RFS.

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“…COPD was defined as FEV 1 /FVC <0.7 (FVC, forced vital capacity) with a smoking history. 2,11) GOLD spirometric grades were used to classify the severity of airflow limitation: GOLD 1 (mild), FEV 1 ≥80% predicted; GOLD 2 (moderate), 50% ≤FEV 1 <80% predicted; GOLD 3 (severe), 30% ≤FEV 1 <50% predicted; and GOLD 4 (very severe), FEV 1 <30% predicted [2]. Patients who had never smoked and smokers without COPD were designated as non-COPD group.…”

Section: Definitionsmentioning

confidence: 99%

Worse Prognosis for Stage IA Lung Cancer Patients with Smoking History and More Severe Chronic Obstructive Pulmonary Disease

Yoshida

Kage

Murakawa

et al. 2015

ATCS

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IntroductionLung cancer is the most commonly diagnosed cancer and the leading cause of cancer death in males worldwide. 1) Tobacco smoking is the best established risk factor for lung cancer and the most common risk factor for chronic obstructive lung disease (COPD). 2) COPD is the fourth leading cause of death worldwide and occurs in 30% of patients with lung cancer. 2) Spirometry is used to assess the risk for perioperative death and cardiopulmonary complications after resection of the lung, with a predicted postoperative forced expiratory volume in one second (FEV 1 ) value of 30% indicating a high risk. 3,4) Purpose: This retrospective study examined whether the severity of chronic obstructive lung disease (COPD) affects surgical outcomes. Methods: The subjects were 243 consecutive patients who underwent lobectomy for clinical stage IA lung cancer from 1999 to 2008 in our hospital. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) grading system was used to classify the severity of COPD in smokers. Results: Among the 149 smokers, 62 were diagnosed with COPD (25 as GOLD 1, 33 as GOLD 2, and 4 as GOLD 3). In univariate analysis, postoperative pulmonary complications were associated with male sex and more severe COPD. The frequencies were 17.1% in non-COPD, 24.0% in GOLD 1-COPD, and 46.0% in GOLD 2/3-COPD smokers (p = 0.0006). In univariate analysis, older age, smoking history, higher smoking pack-years and more severe COPD were associated with poor relapse-free survival. Relapse-free survival at five years was 80.7%, 66.9%, and 61.3% in non-COPD, GOLD 1-COPD, and GOLD 2/3-COPD smokers, respectively (p = 0.0005). Multivariate analyses showed that only GOLD 2/3-COPD was associated with postoperative pulmonary complications and relapse-free survival. Inhaled bronchodilators were prescribed preoperatively to 24.3% of the GOLD 2/3-COPD group. Conclusion: Smokers with GOLD 2/3-COPD are at high risk for pulmonary complications and have an unfavorable long-term prognosis.

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Clinical features of lung cancer in smokers with light and mild chronic obstructive pulmonary disease: a retrospective analysis of Japanese surgical cases

Abstract: We concluded from our analysis that COPD-related LC may have a higher malignant potential than LC in non-COPD smokers, as the histological differentiation grade and clinical outcomes were poorer.

Cited by 15 publications

References 14 publications

Impact of COPD and emphysema on survival of patients with lung cancer: A meta‐analysis of observational studies

Impact of COPD and emphysema on survival of patients with lung cancer: A meta‐analysis of observational studies

Survival significance of coexisting chronic obstructive pulmonary disease in patients with early lung cancer after curative surgery

Worse Prognosis for Stage IA Lung Cancer Patients with Smoking History and More Severe Chronic Obstructive Pulmonary Disease

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