Original articleGeneral thoracicSurvival After Surgical Resection for Lung Cancer in Patients With Chronic Obstructive Pulmonary Disease
Section snippets
Patients and Methods
The Regional Committee for Medical and Health Research Ethics approved this study. Written consent was obtained from all patients.
Characteristics
Among the 688 patients (Table 1), 51 (7.4%) had severe or very severe COPD, GOLD stage III and IV, and 404 (58.7%) had mild to moderate COPD, GOLD stage I and II. The remaining 233 patients (33.9%) had normal lung function (Fig 1). The three groups were comparable with respect to age and distribution of tumor stage but differed significantly with respect to BMI, pack-years of smoking, ECOG status, histologic subtype, surgical technique, and type of surgical resection. There were no
Comment
In the present study, 66% of patients operated on for NSCLC had spirometry-defined COPD. Severe COPD was not associated with early death, which may indicate that it is safe to offer surgical treatment to selected patients with severe airway obstruction with respect to postoperative complications. At 2 and 5 years after the operation, patients with severe COPD had an increased risk of death compared with patients with mild to moderate COPD or normal lung function. Similar long-term survival
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2018, Annals of Thoracic SurgeryCitation Excerpt :These findings again support the argument that additional comorbidity granularity, such as the inclusion of pulmonary function testing, may be warranted in the NCDB. Comorbidities such as chronic obstructive pulmonary disease are highly relevant to the study of thoracic oncology (and to the specific analysis at hand, in which fitness for surgical therapy is evaluated) and are known to contribute to negative outcomes in patients with lung cancer, but to date they remain unmeasured in this data source [21]. We show that in patients with stage I NSCLC treatment at centers with higher use of surgical therapy confers a survival advantage over treatment at centers with lower propensity to provide surgical therapy.
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