Department of Medical Oncology, The Second Medical Centre, Chinese People's Liberation Army General Hospital, Beijing, China.
Department of Respiratory Diseases, The Second Medical Centre, Chinese People's Liberation Army General Hospital, Beijing, China.
Cancer Med. 2019 Aug;8(9):4124-4134. doi: 10.1002/cam4.2333. Epub 2019 Jun 11.
Chronic obstructive pulmonary disease (COPD) and NSCLC often coexist and have poor prognoses, but studies investigating the impact of COPD on NSCLC have reported inconsistent findings. The objective of this study was to compare survival between NSCLC patients with and without COPD.
Medical records were retrospectively collected from 301 elderly patients pathologically diagnosed with NSCLC from the Chinese PLA General Hospital. Ultimately, a total of 200 patients were enrolled in the analysis. The survival rates between the COPD-NSCLC and non-COPD NSCLC were assessed using log-rank and Cox proportional hazard regression analyses.
A total of 117 COPD-NSCLC and 93 non-COPD NSCLC patients were enrolled in the analysis. The median overall survival times were 108.5 months in the non-COPD group and 45.0 months in the COPD group (HR: 2.05; 95% CI, 1.36-2.97, P = 0.0004). After 118 patients underwent propensity score matching, the median overall survival times were 100.6 months in the non-COPD group and 51.9 months in the COPD group (HR: 1.59; 95% CI, 1.096-2.64, P = 0.0459). The multivariate analysis showed that presence of COPD (HR 1.619, P = 0.030), old age (HR 1.007, P < 00001), an advanced disease stage (stage Ⅲ HR 5.513, P < 0.0001; stage Ⅳ HR 11.743, P < 0.0001), the squamous cell carcinoma histological subtype (HR 3.106, P < 0.0001), the presence of a cough (HR 2.463, P = 0.001) a higher serum carcinoembryonic antigen level (HR 1.001, P = 0.023) and higher NRL (HR 2.615, P = 0.007) were independent factors that were significantly associated with poorer survival.
A diagnosis of COPD had significant poorer survival outcomes in NSCLC than that of patients without COPD in this elderly population.
慢性阻塞性肺疾病（COPD）和非小细胞肺癌（NSCLC）常同时存在且预后较差，但有关 COPD 对 NSCLC 影响的研究结果并不一致。本研究旨在比较 COPD 合并 NSCLC 与非 COPD 合并 NSCLC 患者的生存情况。
回顾性收集中国人民解放军总医院经病理诊断为 NSCLC 的 301 例老年患者的病历资料，最终纳入 200 例患者进行分析。采用 log-rank 和 Cox 比例风险回归分析比较 COPD-NSCLC 和非 COPD-NSCLC 患者的生存率。
共纳入 117 例 COPD-NSCLC 和 93 例非 COPD-NSCLC 患者。非 COPD 组中位总生存期为 108.5 个月，COPD 组为 45.0 个月（HR：2.05；95%CI，1.36-2.97，P=0.0004）。118 例患者行倾向性评分匹配后，非 COPD 组中位总生存期为 100.6 个月，COPD 组为 51.9 个月（HR：1.59；95%CI，1.096-2.64，P=0.0459）。多因素分析显示，COPD 存在（HR 1.619，P=0.030）、年龄较大（HR 1.007，P<0.0001）、疾病晚期（Ⅲ期 HR 5.513，P<0.0001；Ⅳ期 HR 11.743，P<0.0001）、鳞癌组织学亚型（HR 3.106，P<0.0001）、咳嗽（HR 2.463，P=0.001）、癌胚抗原（CEA）水平较高（HR 1.001，P=0.023）、NRL 较高（HR 2.615，P=0.007）是与生存较差显著相关的独立因素。
在该老年人群中，与非 COPD 合并 NSCLC 患者相比，COPD 合并 NSCLC 患者的预后明显较差。
