Survival after repeated surgery for lung cancer with idiopathic pulmonary fibrosis: a retrospective study

Abstract

BackgroundPatients with idiopathic pulmonary fibrosis (IPF) have a high risk of developing lung cancer, but few studies have investigated the long-term outcomes of repeated surgery in such patients. The purpose of this study was to evaluate the surgical outcomes of repeated lung cancer surgery in patients with IPF.MethodsFrom January 2001 to December 2015, 108 lung cancer patients with IPF underwent pulmonary resection at two institutions; 13 of these patients underwent repeated surgery for lung cancer, and their data were reviewed.ResultsThe initial procedures of the 13 patients were lobectomy in 8, segmentectomy in 2, and wedge resection in 3. The subsequent procedures were wedge resection in 10 and segmentectomy in 3. The clinical stage of the second tumor was stage IA in 12 and stage IB in 1. Postoperatively, 3 patients (23.1%) developed acute exacerbation (AE) of IPF and died. The rate of decrease in percent vital capacity was significantly higher in patients with AE than in those without AE (p = 0.011). The 3-year overall survival rate was 34.6%. The causes of death were cancer-related in 7, AE of IPF in 3, and metachronous lung cancer in 1.ConclusionsDespite limited resection, a high incidence of AE was identified. The early and long-term outcomes of repeated surgery in lung cancer patients with IPF were poor because of the high risk of AE of IPF and lung cancer recurrence. Long-term intensive surveillance will be required to determine whether surgical intervention is justified in patients with multiple primary lung cancers and IPF.Electronic supplementary materialThe online version of this article (10.1186/s12890-018-0703-8) contains supplementary material, which is available to authorized users.

Identification of common signatures in idiopathic pulmonary fibrosis and lung cancer using gene expression modeling

“…Previous studies have indicated that patients with IPF are at high risk for lung cancer [10,31,32], and the survival of patients with IPF is clearly related to the development of lung cancer [33,34]. The association between IPF and lung cancer also has been demonstrated by the clinicopathological and imaging characteristics of lung cancer associated with IPF [35,36].…”

Combined pulmonary fibrosis and emphysema and idiopathic pulmonary fibrosis in non-small cell lung cancer: impact on survival and acute exacerbation

“…The annual incidence of AE in patients with IPF has been reported as 5–15% [26]. Additionally, the incidence rate of AE triggered by chemotherapy [27], surgery [28], and radiotherapy [29] is increased in patients with IPF. In our study, the total incidence of AE was 15.7%.…”

Acute exacerbation of interstitial lung disease after radical surgery for lung cancer: a case report

“…AE-IPF always occurs spontaneously without verifiable causes. The incidence of postoperative AE-IPF was reported to be fairly high in patients with lung cancer, ranging from 9% to 24% (4,7,8). Potential etiologic factors included, at the least, but are not limited to the following: preoperative disease hyperactivity, high concentrations of oxygen during the operation, mechanical ventilation, intraoperative mechanical-ventilation-related lung injury, and postoperative reduction of the glucocorticoid dose and other drugs (9).…”