Thorac Cardiovasc Surg 2007; 55(8): 505-508
DOI: 10.1055/s-2007-965645
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Operative Indications for Lung Cancer with Idiopathic Pulmonary Fibrosis

K. Kushibe1 , T. Kawaguchi1 , M. Takahama1 , M. Kimura1 , T. Tojo1 , S. Taniguchi1
  • 1Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Kashihara, Japan
Further Information

Publication History

received April 18, 2007

Publication Date:
19 November 2007 (online)

Abstract

Background: Idiopathic pulmonary fibrosis (IPF) is well known to be associated with lung cancer. However, surgical morbidity and mortality in lung cancer patients with IPF remains unclear. Methods: The data of patients who underwent surgery for non-small cell lung cancer were retrospectively reviewed. Results: Of the 1063 patients with lung cancer, 33 (3.1 %) had IPF. Patients with IPF had significantly higher postoperative pulmonary morbidity and mortality than those without IPF (33.3 vs. 2.0 %; 18.2 vs. 1.3 %, respectively, p < 0.0001). Patients with IPF had a significantly higher incidence of postoperative acute lung injury/acute respiratory distress syndrome (ALI/ARDS) than those without IPF (27.3 vs. 1.3 %, p < 0.0001). IPF patients with postoperative ALI/ARDS had a significantly lower preoperative %FVC than those without postoperative ALI/ARDS (74 ± 9 vs. 103 ± 14 %, p < 0.0001). Conclusions: Lung cancer patients with IPF who have a low preoperative %FVC should be carefully assessed prior to any surgical intervention.

References

  • 1 King T E, Costabel U, Cordier J-F. et al . Idiopathic pulmonary fibrosis: diagnosis and treatment. International consensus statement.  Am J Respir Crit Care Med. 2000;  161 646-664
  • 2 Hubbard R, Venn A, Lewis S, Britton J. Lung cancer and cryptogenic fibrosing alveolitis. A population-based cohort study.  Am J Respir Crit Care Med. 2000;  161 5-8
  • 3 Kramer M R, Berkman N, Mintz B, Godfrey S, Saute M, Amir G. The role of open lung biopsy in the management and outcome of patients with diffuse lung disease.  Ann Thorac Surg. 1998;  65 198-202
  • 4 Lee Y-C, Wu C-T, Hsu H-H, Huang P-M, Chang Y-L. Surgical lung biopsy for diffuse pulmonary disease: experience of 196 patients.  J Thorac Cardiovasc Surg. 2005;  129 984-990
  • 5 Kawasaki H, Kanji N, Yoshida J, Nishimura M, Nishiwaki Y. Postoperative morbidity, mortality, and survival in lung cancer associated with idiopathic pulmonary fibrosis.  J Surg Oncol. 2002;  81 33-37
  • 6 Chiyo M, Sekine Y, Iwata T. et al . Impact of interstitial lung disease on surgical morbidity and mortality for lung cancer: analyses of short-term and long-term outcomes.  J Thorac Cardiovasc Surg. 2003;  126 1141-1146
  • 7 Kumar P, Goldstraw P, Yamada K. et al . Pulmonary fibrosis and lung cancer: risk and benefit analysis of pulmonary resection.  J Thorac Cardiovasc Surg. 2003;  125 1321-1327
  • 8 Fujimoto T, Okazaki T, Matsukura T. et al . Operation for lung cancer in patients with idiopathic pulmonary fibrosis: surgical contraindication?.  Ann Thorac Surg. 2003;  76 1674-1679
  • 9 Bernard G R, Artigas A, Brigham K L. et al . The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes and clinical trial co-ordination.  Am J Respir Crit Care Med. 1994;  149 818-824
  • 10 Flaherty K R, Martinez F J. The role of pulmonary function testing in pulmonary fibrosis.  Opin Pulm Med. 2000;  6 404-410
  • 11 Kutlu C A, Williams E A, Evans T W, Pastorino U, Goldstraw P. Acute lung injury and acute respiratory distress syndrome after pulmonary resection.  Ann Thorac Surg. 2000;  69 376-380
  • 12 Ruffini E, Parola A, Papalia E. et al . Frequency and mortality of acute lung injury and acute respiratory distress syndrome after resection for bronchogenic carcinoma.  Eur J Cardiothorac Surg. 2001;  20 30-37
  • 13 Licker M, de Perrot M, Spiliopoulos A. et al . Risk factors for acute lung injury after thoracic surgery for lung cancer.  Anesth Analg. 2003;  97 1558-1565
  • 14 Carpenter C T, Price P V, Christman B W. Exhaled breath condensate isoprostanes are elevated in patients with acute lung injury or ARDS.  Chest. 1998;  114 1653-1659
  • 15 Quinlan G J, Lamb N J, Tilley R, Evans T W, Gutteridge J M. Plasma hypoxanthine levels in ARDS: implication for oxidant stress, morbidity, and mortality.  Am J Respir Crit Care Med. 1997;  155 479-484
  • 16 Montuschi P, Ciabattoni G, Paredi P. et al . 8-isoprostane as a biomarker of oxidant stress in interstitial lung diseases.  Am J Respir Crit Care Med. 1998;  158 1524-1527
  • 17 Kuwano K, Nakashima N, Isoshima I. et al . Oxidative stress in lung epithelial cells from patients with idiopathic interstitial pneumonias.  Eur Respir J. 2003;  21 232-240
  • 18 Cherniack R M, Colby T V, Flint A. et al . Correlation of structure and function in idiopathic pulmonary fibrosis.  Am J Respir Crit Care Med. 1995;  151 1180-1188
  • 19 Erbes R, Schaberg T, Loddenkemper R. Lung function tests in patients with idiopathic pulmonary fibrosis. Are they helpful for predicting outcome?.  Chest. 1997;  111 51-57
  • 20 Cherniack R M, Colby T V, Flint A. et al . Quantitative assessment of lung pathology in idiopathic pulmonary fibrosis.  Am Rev Respir Dis. 1991;  144 882-900

Dr. Keiji Kushibe

Thoracic and Cardiovascular Surgery
Nara Medical University School of Medicine

840 Shijo-cho

634-8522 Kashihara, Nara

Japan

Phone: + 81 7 44 22 30 51

Fax: + 81 7 44 24 80 40

Email: n-thorac@m3.kcn.ne.jp

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