Skip to main content

Advertisement

SpringerLink
Log in

Outcomes of lung cancer resection for patients with combined pulmonary fibrosis and emphysema

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

Combined pulmonary fibrosis and emphysema (CPFE) has recently been reported as a prognostic factor that may increase the risk of lung cancer for patients with respiratory disorders; however, there have been no reports published on mortality and morbidity following major lung resection for patients with CPFE.

Methods

The subjects of this retrospective study were 1507 patients who underwent surgical resection of lung cancer at our institute between 2008 and 2013. We reviewed the computed tomography findings and divided the patients into four groups: CPFE group, fibrosis group, emphysema group, and normal group. The surgical outcomes of the patients with CPFE were compared with those of the patients in the other groups.

Results

The CPFE group comprised 137 (10.0 %) patients. This group had worse surgical morbidity and mortality rates than either the fibrosis group or the emphysema group. The 90-day mortality rates for the CPFE, fibrosis, and emphysema groups were 7.3, 0, and 3.0 %, respectively. A multivariate analysis of the CPFE group revealed that the distribution of IIP (HR 13.29, p = 0.038) and blood loss (ml) (HR 1.001, p = 0.013) predicted the hazard ratio for 90-day mortality.

Conclusions

The postoperative outcome of patients with CPFE in this study was poor with respect to morbidity and mortality. The high rate of complications and poor survival warrants further investigation of the indications for surgery in patients with CPFE.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kudoh S, Kato H, Nishiwaki Y, Fukuoka M, Nakata K, Ichinose Y, et al. Interstitial lung disease in Japanese patients with lung cancer: a cohort and nested case-control study. Am J Respir Crit Care Med. 2008;177:1348–57.

    Article  PubMed  Google Scholar 

  2. Movsas B, Raffin TA, Epstein AH, Link CJ. Pulmonary radiation injury. Chest. 1997;111:1061–76.

    Article  CAS  PubMed  Google Scholar 

  3. Takeyuki Makimoto ST, Kazushige Hayakawa, Ryusei Saitoh, Masatomo Mori. Risk factors for severe radiation pneumonitis in lung cancer. Jpn J Clin Oncol 1999;29:192–97.

  4. Cottin V, Nunes H, Brillet PY, Delaval P, Devouassoux G, Tillie-Leblond I, et al. Combined pulmonary fibrosis and emphysema: a distinct underrecognised entity. Eur Respir J. 2005;26:586–93.

    Article  CAS  PubMed  Google Scholar 

  5. Jankowich MD, Rounds SI. Combined pulmonary fibrosis and emphysema syndrome: a review. Chest. 2012;141:222–31.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Colice GL, Shafazand S, Griffin JP, Keenan R, Bolliger CT. American College of Chest P. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest. 2007;132:161S–77S.

    Article  PubMed  Google Scholar 

  7. Sato T, Teramukai S, Kondo H, Watanabe A, Ebina M, Kishi K, et al. Impact and predictors of acute exacerbation of interstitial lung diseases after pulmonary resection for lung cancer. J Thorac Cardiovasc Surg 2013.

  8. Hyzy R, Huang S, Myers J, Flaherty K, Martinez F. Acute exacerbation of idiopathic pulmonary fibrosis. Chest. 2007;132:1652–8.

    Article  PubMed  Google Scholar 

  9. Mejia M, Carrillo G, Rojas-Serrano J, Estrada A, Suarez T, Alonso D, et al. Idiopathic pulmonary fibrosis and emphysema: decreased survival associated with severe pulmonary arterial hypertension. Chest. 2009;136:10–5.

    Article  PubMed  Google Scholar 

  10. Akagi T, Matsumoto T, Harada T, Tanaka M, Kuraki T, Fujita M, et al. Coexistent emphysema delays the decrease of vital capacity in idiopathic pulmonary fibrosis. Respir Med. 2009;103:1209–15.

    Article  PubMed  Google Scholar 

  11. Kwak N, Park CM, Lee J, Park YS, Lee SM, Yim JJ, et al. Lung cancer risk among patients with combined pulmonary fibrosis and emphysema. Respir Med. 2014;108:524–30.

    Article  PubMed  Google Scholar 

  12. Kitaguchi Y, Fujimoto K, Hanaoka M, Kawakami S, Honda T, Kubo K. Clinical characteristics of combined pulmonary fibrosis and emphysema. Respirology. 2010;15:265–71.

    Article  PubMed  Google Scholar 

  13. Usui K, Tanai C, Tanaka Y, Noda H, Ishihara T. The prevalence of pulmonary fibrosis combined with emphysema in patients with lung cancer. Respirology. 2011;16:326–31.

    Article  PubMed  Google Scholar 

  14. Papiris SA, Triantafillidou C, Manali ED, Kolilekas L, Baou K, Kagouridis K, et al. Combined pulmonary fibrosis and emphysema. Expert Rev Resp Med 2013;7:19–31 (quiz 32).

  15. Minegishi Y, Kokuho N, Miura Y, Matsumoto M, Miyanaga A, Noro R, et al. Clinical features, anti-cancer treatments and outcomes of lung cancer patients with combined pulmonary fibrosis and emphysema. Lung Cancer. 2014;85:258–63.

    Article  PubMed  Google Scholar 

  16. Girard Nicolas, Marchand-Adam Sylvain, Naccache Jean-Marc, Borie Raphael, Urban Thierry, Jouneau Stephane, et al. Lung cancer in combined pulmonary fibrosis and emphysema A series of 47 western patient. J Thorac Oncol. 2014;9:1162–70.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported in part by the National Cancer Center Research and Development Fund (26-A-4). We thank the doctors working in respiratory medicine and anesthesiology at Juntendo University.

Author information

Authors and Affiliations

  1. Department of General Thoracic Surgery, Juntendo University School of Medicine, 1-3, Hongo 3-chome, Bunkyo-ku, Tokyo, 113-8431, Japan

    Mariko Fukui, Kenji Suzuki, Takeshi Matsunaga, Shiaki Oh & Kazuya Takamochi

Authors
  1. Mariko Fukui
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kenji Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takeshi Matsunaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shiaki Oh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kazuya Takamochi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kenji Suzuki.

Ethics declarations

Conflict of interest

Mariko Fukui and the other co-authors have no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fukui, M., Suzuki, K., Matsunaga, T. et al. Outcomes of lung cancer resection for patients with combined pulmonary fibrosis and emphysema. Surg Today 46, 341–347 (2016). https://doi.org/10.1007/s00595-015-1234-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-015-1234-z

Keywords

Search

Navigation