Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Anticancer Res. 2023 Nov;43(11):5215-5222. doi: 10.21873/anticanres.16723.
BACKGROUND/AIM: Recent advances in surgery, such as thoracoscopic surgery, have made it possible to treat patients with chronic obstructive pulmonary disease (COPD) more safely than before. This study evaluated the short- and long-term prognosis of lobectomy in non-small cell lung cancer (NSCLC) patients with COPD.
This retrospective, propensity-matched, cohort analysis was conducted from January 2014 to December 2018. Among 441 patients who underwent lobectomy for NSCLC, 158 (35.8%) had a preoperative diagnosis of COPD. Propensity-matched analysis, incorporating preoperative variables, was used to compare postoperative hospital stay and complications, and long-term prognosis between the groups.
Propensity matching estimated 145 patients in each group. There was no difference between the two groups for length of postoperative hospital stay (12 vs. 11 days, p=0.306). Postoperative complications were more frequent in the COPD group (24.1%) than in the non-COPD group (16.6%), but the difference was not significant (p=0.108). The 5-year overall survival rate was 86.2% in the COPD group and 82.1% in the non-COPD group after matching (p=0.580). The corresponding 5-year recurrence-free survival rate was 72.8% in the COPD group and 67.2% in the non-COPD group after matching (p=0.601).
In case of Global Initiative for Chronic Obstructive Lung Disease (GOLD) I/II classification, COPD did not significantly worsen the prognosis of patients with NSCLC after lobectomy.
背景/目的：近年来，手术领域的进步，如胸腔镜手术，使得治疗慢性阻塞性肺疾病（COPD）患者比以往更加安全。本研究评估了 COPD 患者行非小细胞肺癌（NSCLC）肺叶切除术的短期和长期预后。
这是一项回顾性、倾向评分匹配的队列分析，时间范围为 2014 年 1 月至 2018 年 12 月。在 441 例行 NSCLC 肺叶切除术的患者中，有 158 例（35.8%）术前诊断为 COPD。采用倾向评分匹配分析，纳入术前变量，比较两组患者术后住院时间和并发症以及长期预后。
倾向评分匹配后，每组各有 145 例患者。两组患者术后住院时间（12 天比 11 天，p=0.306）无差异。COPD 组术后并发症发生率（24.1%）高于非 COPD 组（16.6%），但差异无统计学意义（p=0.108）。匹配后，COPD 组的 5 年总生存率为 86.2%，非 COPD 组为 82.1%（p=0.580）。匹配后，COPD 组的 5 年无复发生存率为 72.8%，非 COPD 组为 67.2%（p=0.601）。
在全球慢性阻塞性肺疾病倡议（GOLD）I/II 分类中，COPD 并未显著恶化行肺叶切除术的 NSCLC 患者的预后。
