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Perioperative pirfenidone treatment as prophylaxis against acute exacerbation of idiopathic pulmonary fibrosis: a single-center analysis

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Abstract

Purpose

Lung cancer in patients with idiopathic pulmonary fibrosis (IPF) is associated with a poor prognosis and postoperative acute exacerbation (AE) of IPF is a fatal complication. Studies have shown that perioperative pirfenidone treatment (PPT) may reduce the incidence of AE-IPF. We evaluated the efficacy of PPT in preventing AE-IPF and improving overall survival.

Methods

The subjects of this study were 56 patients with IPF who underwent resection of lung cancer in our hospital between January, 2011 and September, 2016. Pirfenidone was administered to patients from 4 weeks before the operation and continued for longer periods. Thirty-six patients received PPT and their outcome was compared with that of the other 20 patients who did not.

Results

There were no differences in age, gender, smoking history, respiratory function, or surgical procedures between the groups. AE-IPF developed in three patients (8%) in the PPT group and four (20%) patients in the non-PPT group, without a significant difference between the groups. The interval was significantly longer in the PPT group (p = 0.03). PPT reduced postoperative mortality significantly (p = 0.04).

Conclusions

Although perioperative pirfenidone treatment did not obviously prevent postoperative AE-IPF, it may reduce the mortality of lung cancer patients with IPF.

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Authors and Affiliations

  1. Division of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan

    Keigo Sekihara, Keiju Aokage, Tomohiro Miyoshi, Kenta Tane & Masahiro Tsuboi

  2. Course of Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan

    Keigo Sekihara & Genichiro Ishii

  3. Division of Pathology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Genichiro Ishii

Authors
  1. Keigo Sekihara
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  2. Keiju Aokage
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  3. Tomohiro Miyoshi
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  4. Kenta Tane
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  5. Genichiro Ishii
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  6. Masahiro Tsuboi
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Correspondence to Keiju Aokage.

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Sekihara, K., Aokage, K., Miyoshi, T. et al. Perioperative pirfenidone treatment as prophylaxis against acute exacerbation of idiopathic pulmonary fibrosis: a single-center analysis. Surg Today 50, 905–911 (2020). https://doi.org/10.1007/s00595-020-01978-9

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  • DOI: https://doi.org/10.1007/s00595-020-01978-9

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