Does presence of chronic obstructive pulmonary disease (COPD) influence clinical behavior in patients with early-stage non-small cell lung cancer (ESNSCLC)?

Abstract

e18530 Background: CDPD and lung cancer sometimes occurs simultaneously. COPD has been recognized as an inflammatory disease and may potentially affect biology of the accompanying tumor. It is not fully understood whether presence of CDPD influences clinical characteristics, pathological findings and/or clinical outcomes in patients with ESNSCLC. Methods: Retrospective and consecutive data were collected from the medical records of patients who underwent surgical resections at Kinki-chuo Chest Medical Center, Japan, between January 2009 and December 2010. CDPD status was classified as absence of COPD, stage I and II COPD based on the criteria of Global Initiative for Chronic Obstructive Lung Disease (GOLD). Histology, vascular / lymphatic invasion and the status of epidermal growth factor receptor (EGFR) were determined using the surgical materials. Results: A total of 319 cases was included with median age of 67 (range, 36 - 89). There were 81 cases of relapse and 40 cases of death during the median follow up of 28 months (11 days to 49 months). In the subgroup of non-COPD, stage I and II COPD, the median age, the number of case in gender (male/female), performance status (PS, 0/1), histology (squamous cell carcinoma [SQ] /non SQ), smoking status (never/ever), and EGFR status (wild type/mutant) were 67, 72, 72 (p<0.001) and 105/110, 48/12, 38/6 (p<0.001) and 170/40, 53/7, 27/14 (p=0.029) and 31/184, 12/48, 14/28 (p<0.001) and 89/122, 7/53, 2/39 (p=0.002) and 47/37, 21/3, 9/3 (p=0.013), respectively. No significant difference was observed in disease-free survival (DFS, log-rank p=0.411) and overall survival (OS, log-rank p=0.127) between the patients with and without COPD. In multivariate analysis adjusted for age, gender, PS, histology, smoking status, pathological stage, vascular / lymphatic invasion and EGFR status, presence of COPD did not affect DFS (HR=1.457, p = 0.279) nor OS (HR=0.993, p = 0.990).Conclusions: Although COPD was significantly associated with the elderly, male gender, presence of symptoms, SQ histology, ever smoking, and wild type EGFR, it did not add values of prognostic factors in patients with ESNSCLC.

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

“…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.…”

“…Table 1 presents the characteristics of 21 studies for concomitant COPD and lung cancer survival. 3,5,[13][14][15][16]20,[22][23][24][25]27,29,30,[32][33][34][35][36][37][38] These studies were published between 2001 and 2015. Of these, six studies were conducted in the United States, 3,13,23,25,32,35 seven in European countries 5,15,16,29,30,33,34 and eight in Asian countries.…”

“…Of these, six studies were conducted in the United States, 3,13,23,25,32,35 seven in European countries 5,15,16,29,30,33,34 and eight in Asian countries. 14,20,22,24,27,[36][37][38] The sample size ranged from 114 to 18 077, resulting in a total of 60 764 participants and 11 270 cases across these studies. Seven studies included only patients undergoing surgery, 13,20,22,24,27,35,38 and in two studies, 29,37 treatment was not reported.…”

“…14,20,22,24,27,[36][37][38] The sample size ranged from 114 to 18 077, resulting in a total of 60 764 participants and 11 270 cases across these studies. Seven studies included only patients undergoing surgery, 13,20,22,24,27,35,38 and in two studies, 29,37 treatment was not reported. In defining COPD, 14 studies used spirometry, 3,[14][15][16]20,22,24,25,27,[33][34][35][36]38 and the remaining seven studies used medical records or self-report data.…”

“…Seven studies included only patients undergoing surgery, 13,20,22,24,27,35,38 and in two studies, 29,37 treatment was not reported. In defining COPD, 14 studies used spirometry, 3,[14][15][16]20,22,24,25,27,[33][34][35][36]38 and the remaining seven studies used medical records or self-report data. 5,13,23,29,30,32,37 Regarding study design, 19 were retrospective cohort studies 3,5,13,14,16,20,[22][23][24][25]27,29,[32][33][34][35][36][37][38] and two were prospective cohort studies.…”