Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, 676 N St. Clair Street, Suite 1400, Chicago, IL 60611, USA.
Am J Respir Crit Care Med. 2011 May 1;183(9):1138-46. doi: 10.1164/rccm.201008-1274CI. Epub 2010 Dec 22.
Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for both the development of primary lung cancer, as well as poor outcome after lung cancer diagnosis and treatment. Because of existing impairments in lung function, patients with COPD often do not meet traditional criteria for tolerance of definitive surgical lung cancer therapy. Emerging information regarding the physiology of lung resection in COPD indicates that postoperative decrements in lung function may be less than anticipated by traditional prediction tools. In patients with COPD, more inclusive consideration for surgical resection with curative intent may be appropriate as limited surgical resections or nonsurgical therapeutic options provide inferior survival. Furthermore, optimizing perioperative COPD medical care according to clinical practice guidelines including smoking cessation can potentially minimize morbidity and improve functional status in this often severely impaired patient population.
慢性阻塞性肺疾病（COPD）患者发生原发性肺癌以及肺癌诊断和治疗后预后不良的风险均增加。由于肺功能已经受损，COPD 患者通常不符合传统的确定性肺癌治疗耐受标准。COPD 患者肺切除生理学方面的新信息表明，术后肺功能下降可能比传统预测工具预计的要小。对于 COPD 患者，更全面地考虑进行有治愈意图的手术切除可能是合适的，因为有限的手术切除或非手术治疗选择提供的生存获益较差。此外，根据包括戒烟在内的临床实践指南优化 COPD 围手术期医疗护理，有可能使这一常伴有严重功能障碍的患者人群的发病率和功能状态最小化。
