초록접수 현황
| 19F-240 | 구연 발표 |
Risk Factors of Surgical Resection for Lung Cancer Patients with Idiopathic Pulmonary Fibrosis Incidentally found on Preoperative Chest Computed Tomography
Seok Kim¹, Do Wan Kim², Ju Sik Yun¹, Kyo Seon Lee², In Seok Jeong², Sang Yun Song¹, Kook Joo Na¹
¹Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hwasun Hospital, Chonnam National University College of Medicine, Jeollanam-do, Republic of Korea, ²Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, Gwangju, Republic of Korea
Purpose : The aim of this study was to evaluate the risk factors of surgical treatment for lung cancer combined with idiopathic pulmonary fibrosis (IPF).
Methods : In our institution, a total of 1,673 patients underwent surgical resection for lung cancer between January 2004 and December 2015. Fifty-seven (3.4%) of 1,673 patients showed IPF on preoperative chest computed tomography (CT). Overall, 53 patients were retrospectively evaluated. Their characteristics, perioperative variables, recurrence, and survival rates were retrieved based on medical records and radiological reports.
Results : The mean follow-up duration was 33.2±39.1 months (0.4-184.4). Thirty patients (69.8%) experienced late mortality at the end of the follow-up period. Five patients (9.4%) showed postoperative acute exacerbation (PAE) of IPF and died in the hospital. Twelve surgeries involved wedge resections of the lung (22.6%), 38 were lobectomies (71.7%), 2 bilobectomies (3.8%), and 1 pneumonectomy (1.9%). Lobectomy or more extensive resection of the lung was associated with significantly higher morbidity (P=0.003) than that with wedge resection, but there was no significant difference in recurrence-free survival (P=0.202) and overall survival (P=0.311). Upon univariate analysis, the Brinkman index, which is a measure of the smoking history of a patient, was found to be associated with significantly more frequent PAE in IPF patients, and it significantly lowered the overall survival in multivariate logistic regression analysis (hazard ratio: 2.50, 95% confidence interval 1.10-5.71 P=0.029).
Conclusion : Surgical resection may be recommended when IPF is found in preoperative evaluation for lung cancer patients who are non-smokers or have a history of low amount of smoking.
Methods : In our institution, a total of 1,673 patients underwent surgical resection for lung cancer between January 2004 and December 2015. Fifty-seven (3.4%) of 1,673 patients showed IPF on preoperative chest computed tomography (CT). Overall, 53 patients were retrospectively evaluated. Their characteristics, perioperative variables, recurrence, and survival rates were retrieved based on medical records and radiological reports.
Results : The mean follow-up duration was 33.2±39.1 months (0.4-184.4). Thirty patients (69.8%) experienced late mortality at the end of the follow-up period. Five patients (9.4%) showed postoperative acute exacerbation (PAE) of IPF and died in the hospital. Twelve surgeries involved wedge resections of the lung (22.6%), 38 were lobectomies (71.7%), 2 bilobectomies (3.8%), and 1 pneumonectomy (1.9%). Lobectomy or more extensive resection of the lung was associated with significantly higher morbidity (P=0.003) than that with wedge resection, but there was no significant difference in recurrence-free survival (P=0.202) and overall survival (P=0.311). Upon univariate analysis, the Brinkman index, which is a measure of the smoking history of a patient, was found to be associated with significantly more frequent PAE in IPF patients, and it significantly lowered the overall survival in multivariate logistic regression analysis (hazard ratio: 2.50, 95% confidence interval 1.10-5.71 P=0.029).
Conclusion : Surgical resection may be recommended when IPF is found in preoperative evaluation for lung cancer patients who are non-smokers or have a history of low amount of smoking.
첨부파일 : Table.docx
책임저자: Kook Joo Na
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hwasun Hospital, Chonnam National University College of Medicine, Jeollanam-do, Republic of Korea
발표자: Seok Kim, E-mail : bluedocseok@cnuh.com