Effect of collagen vascular disease-associated interstitial lung disease on the outcomes of lung cancer surgery

Hideyuki Maeda,Kunihiro Oyama,Tamami Isaka,Takamasa Onuki,Masahide Murasugi,Masato Kanzaki,Kei Sakamoto

doi:10.1007/s00595-017-1476-z

Hideyuki Maeda, Kunihiro Oyama + Show 5 more

Open Access

https://doi.org/10.1007/s00595-017-1476-z

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Abstract

PurposeThis study compared the effect of collagen vascular disease-associated interstitial lung disease (CVD-ILD) with that of idiopathic interstitial pneumonias (IIPs) on the outcomes of lung cancer surgery.MethodsThis study retrospectively reviewed the medical records of patients who underwent surgery for non-small cell lung cancer (NSCLC) and compared the data of 16 patients with CVD-ILD with those of 70 patients with IIPs. The patterns of interstitial lung disease (ILD) on chest computed tomography were classified into usual interstitial pneumonia (UIP) and non-specific interstitial pneumonia (NSIP) patterns.ResultsThe numbers of UIP and NSIP patterns were 10 (62.5%) and 6 (37.5%) patients in CVD-ILD group, and 62 (88.6%) and 8 (11.4%) patients in IIPs group, respectively. A postoperative acute exacerbation (AE) appeared in 1 patient (6.3%) in the CVD-ILD group and 6 patients (8.6%) in the IIPs group. No significant differences in the incidence of postoperative AE and mortalities were observed between the two groups. The five-year overall survival rates of the CVD-ILD and IIPs groups were 37.5 and 49.2%, respectively.ConclusionsSurgery for NSCLC in CVD-ILD patients appear to cause no increase in postoperative AE and mortality in comparison to that seen in IIPs patients. Similar to IIPs, CVD-ILD might therefore affect the prognosis of resected NSCLC.

Highlights

Interstitial lung disease (ILD) frequently coexists with collagen vascular disease (CVD) in patients, and most such patients are treated with immunosuppressive agents
ILD patterns on chest computed tomography (CT) in CVD-associated ILD (CVD-ILD) group were found in 10 patients with a usual interstitial pneumonia (UIP) pattern, and in 6 patients with an non-specific interstitial pneumonia (NSIP) pattern
Pathological examinations of resected specimens showed that 7 UIP pattern cases with rheumatoid arthritis (RA) were found in the CVD-ILD group, 18 UIP pattern cases were found in the interstitial pneumonias (IIPs) group, and one NSIP pattern was found

Summary

Introduction

Interstitial lung disease (ILD) frequently coexists with collagen vascular disease (CVD) in patients, and most such patients are treated with immunosuppressive agents. Fukui et al report that patients with combined pulmonary fibrosis and emphysema show poor postoperative outcomes after lung cancer surgery [1]. The prognosis of CVD-associated ILD (CVD-ILD) is better than that of idiopathic interstitial pneumonias (IIPs) [2], the effect of CVD-ILD on the prognosis of lung cancer compared to that of IIPs and the incidence of postoperative AE of CVD-ILD are unknown. CVD-ILD patients undergoing lung cancer surgery are speculated to have a higher risk of postoperative morbidities and mortality. To date, there is no report regarding the outcomes of lung cancer surgery in CVD-ILD patients. This study compared the effect of CVD-ILD with that of patients with IIPs on the outcomes of lung cancer surgery

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