P3-262: Systematic mediastinal lymphadenectomy results in local and systemic immunosuppression after lung cancer surgery

Abstract

Objective: Chronic obstructive pulmonary disease (COPD) poses a high risk for postoperative pulmonary complications after lung cancer surgery. We sought to determine the impact of this disease on long-term survival after surgical resection and to identify prognostic factors. Methods: A retrospective chart review was done of 251 male patients with pathological stage IA lung cancer who had a lobectomy with systematic lymph node dissection (17.2%) out of 1461 patients who underwent lung cancer surgery at our hospital from January 1990 to April 2005. The functional definition of COPD, according to the spirometric guidelines of the Global Initiative for Chronic Obstructive Lung Disease, was (forced expiratory volume in 1 second) /(forced vital capacity) < 70%. The postoperative complications were compared between the non-COPD (178 patients) and COPD (73 patients) groups. Overall survival and disease-free interval were analyzed using the Kaplan-Meier method and log rank test. Prognostic factors were identified by univariate and multivariate analyses. Results:The frequencies of all pulmonary complications except pneumonia were similar between the two groups. Overall survival and disease-free interval in the COPD group were significantly worse than those in the non-COPD group (p<.05). Prognostic factors were tumor size and severity of COPD. Conclusion: Although the incidences of postoperative complications were acceptable in patients with COPD, these patients had poorer longterm survivals due to higher incidence of tumor recurrence. We should be watchful not only for postoperative functional deterioration but also for higher recurrence of lung cancer in patients with COPD.

Viscothionin Suppresses Human Non-small Cell Lung Cancer via Inhibiting the STAT3 Signaling Pathway

“…Cytokines and growth factors, such as interleukin 6 (IL-6), activates STAT3 as a transcription factor [12]. Level of IL-6 is associated with postoperative complication and postoperative recurrence of lung cancer [13]. Previous studies suggest that IL-6 promotes lung cancer cell migration and proliferation through activation of STAT3 [14].…”