P3.04-036 Clinical Analysis of the Association between Lung Cancer and Connective Tissue Disease: Topic: Miscellaneous II

Abstract

Connective tissue disease (CTD) is an autoimmune disease, and immunosuppressive agents, such as steroids, are used in its treatment. According to previous reports, the overall incidence of malignancies in patients with CTD is comparable or slightly higher than that in the general population. Therefore, we hypothesized that the prognosis of lung cancer patients with CTD is unfavorable. Here we assessed the clinical characteristics and prognosis of patients with lung cancer complicated with CTD. We retrospectively reviewed the records of patients with lung cancer who underwent surgery during April 2006 and March 2015 at our institution. A total of 1,104 patients underwent pulmonary resection for primary lung cancer, and it included 45 patients with CTD (25 men and 20 women). The median age of patients with CTD was 69 years (range, 50–83 years). Thirty-two patients had rheumatoid arthritis, five had systemic sclerosis, five had dermatomyositis, two had systemic lupus erythematosus, and one had Sjögren syndrome. Further, 8 patients had interstitial pneumonia at preoperative imaging, 12 patients had obstructive pulmonary dysfunction, and 4 had restrictive pulmonary dysfunction. The distribution of patients according to cancer types was as follows: 27 had adenocarcinoma, 11 had squamous cell carcinoma, 1 had small cell carcinoma and 6 had other types. A total of 18 patients underwent thoracotomy, and 27 underwent VATS (5 wedge resection, 2 segmentectomy, 37 lobectomy, and 1 pneumonectomy). In all, 22 patients had pathological stage IA disease, 9 had stage IB, 3 had stage IIA, 3 had stage II B, 5 had stage IIIA, and 1 had stage IV. There was no significant differences in the pathological stage between patients with CTD and other patients (p = 0.74).The median follow-up period of patients with CTD was 32.6 months. No deaths occurred within 30 days post -surgery. The 5-year overall survival rate was lower in patients with CTD (68.6%) than in patients without CTD (74.0%) (p = 0.10). In univariate analysis, interstitial pneumonia was a prognostic factor (p < 0.0001). However, there was no significant difference in the existence of CTD (p = 0.10). Pulmonary resection in patients with CTD in our study was safe because of careful management during the perioperative period. Regular imaging follow-up for CTD enabled the early diagnosis of lung cancer, and postoperative prognosis was favorable.