Qiang Guangliang, Liang Chaoyang, Xiao Fei, Yu Qiduo, Wen Huanshun, Song Zhiyi, Tian Yanchu, Shi Bin, Guo Yongqing, Liu Deruo
Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2015 Dec 29;11:43-9. doi: 10.2147/COPD.S97411. eCollection 2016.
This study aimed to determine whether the severity of chronic obstructive pulmonary disease (COPD) affects recurrence-free survival in non-small-cell lung cancer (NSCLC) patients after surgical resection.
A retrospective study was performed on 421 consecutive patients who had undergone lobectomy for NSCLC from January 2008 to June 2011. Classification of COPD severity was based on guidelines of the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Characteristics among the three subgroups were compared and recurrence-free survivals were analyzed.
A total of 172 patients were diagnosed with COPD (124 as GOLD-1, 46 as GOLD-2, and two as GOLD-3). The frequencies of recurrence were significantly higher in patients with higher COPD grades (P<0.001). Recurrence-free survival at 5 years was 78.1%, 70.4%, and 46.4% in non-COPD, mild COPD, and moderate/severe COPD groups, respectively (P<0.001). By univariate analysis, the age, sex, smoking history, COPD severity, tumor size, histology, and pathological stage were associated with recurrence-free survival. Multivariate analysis showed that older age, male, moderate/severe COPD, and advanced stage were independent risk factors associated with recurrence-free survival.
NSCLC patients with COPD are at high risk for postoperative recurrence, and moderate/severe COPD is an independent unfavorable prognostic factor.
本研究旨在确定慢性阻塞性肺疾病（COPD）的严重程度是否会影响非小细胞肺癌（NSCLC）患者手术切除后的无复发生存率。
对2008年1月至2011年6月期间连续421例行NSCLC肺叶切除术的患者进行回顾性研究。COPD严重程度分类依据慢性阻塞性肺疾病全球倡议（GOLD）指南。比较三个亚组的特征并分析无复发生存率。
共有172例患者被诊断为COPD（124例为GOLD-1级，46例为GOLD-2级，2例为GOLD-3级）。COPD分级较高的患者复发频率显著更高（P<0.001）。非COPD组、轻度COPD组和中度/重度COPD组的5年无复发生存率分别为78.1%、70.4%和46.4%（P<0.001）。单因素分析显示，年龄、性别、吸烟史、COPD严重程度、肿瘤大小、组织学类型和病理分期与无复发生存率相关。多因素分析表明，年龄较大、男性、中度/重度COPD和晚期是与无复发生存率相关的独立危险因素。
合并COPD的NSCLC患者术后复发风险高，中度/重度COPD是独立的不良预后因素。
