Impact of idiopathic pulmonary fibrosis on recurrence after surgical treatment for stage I–III non-small cell lung cancer

Abstract

Background Idiopathic pulmonary fibrosis (IPF) is an independent risk factor for lung cancer (LC) development; however, its effect on recurrence after curative surgery remains unclear. Objectives This study aimed to determine the impact of IPF on recurrence-free survival following curative surgical resection of stage I-III non-small cell lung cancer (NSCLC) and investigate the effects of patient and surgical factors on the risk of recurrence. Methods We reviewed retrospectively collected data of patients with surgically resected stage I-III NSCLC from two tertiary care hospitals in South Korea. By propensity score matching, patients with IPF (LC with IPF) were matched to those without IPF (LC without IPF). Results In total, 3416 patients underwent surgical resection, and 96 were diagnosed with underlying IPF. In the LC with IPF group, 89.6% patients were men, and the average age was 69.7 years. Sublobar resection was performed more frequently in the LC with IPF group than in the LC without IPF group, while the rate of mediastinal lymph node dissection and dissected node number were lower in the former group. The 5-year recurrence-free survival rate was significantly lower in the LC with IPF group (49.2%) than in the LC without IPF group (69.1%; P<0.001). Multivariable Cox regression analysis revealed that IPF and postoperative stage III were independent risk factors for recurrence.

Lung cancer resection in patients with underlying usual interstitial pneumonia: a meta-analysis

“…The impact of UIP on disease-free interval must be interpreted cautiously, some groups have reported no difference 27 whereas others have demonstrated a significantly worse disease free interval with underlying UIP. 28 This must be stratified according to the type of surgical resection as lesser resections are often employed in UIP patients to protect against disease AE postoperatively. As we shall explore later, lesser resections do associate with higher rates of locoregional recurrence.…”

“…Despite having a variable prevalence, some groups reporting up to 13%,19 UIP is consistently recognised as a significant independent negative prognostic factor in terms of postoperative pulmonary complications, in-hospital mortality and overall survival (online supplemental table 2). The impact of UIP on disease-free interval must be interpreted cautiously, some groups have reported no difference27 whereas others have demonstrated a significantly worse disease free interval with underlying UIP 28. This must be stratified according to the type of surgical resection as lesser resections are often employed in UIP patients to protect against disease AE postoperatively.…”

Impact of concomitant idiopathic pulmonary fibrosis on prognosis in lung cancer patients: A meta-analysis

“…The main characteristics of all 12 studies that met our inclusion and exclusion criteria were displayed in Table 1 [34][35][36][37][38][39][40][41][42][43][44][45].…”

“…Of all included studies, 10 were conducted in Asia [35-42, 44, 45] and the rest were in the United States of America (USA) [34,43]. All 12 studies were retrospective, consist of 1 casecontrol study [39] and 11 cohort studies [34][35][36][37][38][40][41][42][43][44][45]. The sample size ranged from 86 to 54453.…”

“…Of all studies, 10 enrolled patients with NSCLC [34-38, 40, 41, 43, 45] while 2 enrolled SCLC patients [42,44]. Patients of 7 studies received surgery [34][35][36][37][38][39]45] while 4 studies received chemotherapy, radiotherapy, or target therapy [40][41][42]44]. All studies defined OS as the time from diagnosis to the day of death or last follow-up.…”