Clinical impact of prevalence and severity of COPD on the decision-making process for therapeutic management of lung cancer patients

BMC Pulmonary Medicine

Yoshinori Hasegawa¹  Kohei Yokoi²  Kazuyoshi Imaizumi³  Kenji Wakai⁵  Shingo Iwano⁴  Naoyuki Imai¹  Yu Okada¹  Asuka Matsuzaki¹  Naozumi Hashimoto¹ 

[1] Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan;Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan;Department of Respiratory Medicine and allergy, Fujita Health University, Toyoake, Japan;Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan;Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan

关键词: Japanese population;    Thoracic surgery;    Spirometry screening assessment;    Bronchoscopy;    Chronic obstructive lung disease;   

Others  :  865436
DOI  :  10.1186/1471-2466-14-14

 received in 2013-11-15, accepted in 2014-02-03,  发布年份 2014

【 摘 要 】

Background

Recent studies suggest that coexistence of chronic obstructive pulmonary disease (COPD) might be independently related to a worse prognosis for lung cancer. However, because data on the substantial prevalence of COPD and its severity in Asian lung cancer patients remain limited, clinical impact of prevalence and severity of COPD among the population has not been fully evaluated. Furthermore, patients with COPD often have comorbidities. Thus, whether the decision-making process for therapeutic management of lung cancer patients might be independently affected by COPD remains elusive.

Methods

Clinical impact of prevalence and severity of COPD were evaluated in 270 Japanese patients with newly diagnosed lung cancer who were sequentially registered and underwent bronchoscopy from August 2010 to July 2012 at Nagoya University hospital. Furthermore, to explore whether or not the severity of airflow obstruction might affect the decision to propose thoracic surgery with curative intent, we evaluated data from patients with lung cancer at stage 1A to 3A who underwent spirometry and bronchoscopy.

Results

The prevalence rate of COPD was 54.4% among Japanese patients with lung cancer who underwent bronchoscopy. The incidence of Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 1 and 2 was significantly higher than that of GOLD grade 3. Although COPD-related comorbidities were not independent factors for proposing thoracic surgery, the number of thoracic surgeries performed was significantly less in the COPD group than the non-COPD group. Multivariate analysis showed that more severe airway obstruction, advanced clinical staging, and higher age, were independent factors associated with the decision on thoracic surgery.

Conclusions

We demonstrated a high prevalence of COPD among Japanese lung cancer patients. Based on the knowledge that severity of COPD is one of the most important factors in the therapeutic decision, comprehensive assessment of COPD at bronchoscopy might allow us to implement the optimum management for lung cancer patients.

【 授权许可】

   
2014 Hashimoto et al.; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]Mathers CD, Loncar D: Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 2006, 3(11):e442.
• [2]Mannino DM, Buist AS: Global burden of COPD: risk factors, prevalence, and future trends. Lancet 2007, 370(9589):765-773.
• [3]Sekine Y, Behnia M, Fujisawa T: Impact of COPD on pulmonary complications and on long-term survival of patients undergoing surgery for NSCLC. Lung Cancer 2002, 37(1):95-101.
• [4]Lopez-Encuentra A, Astudillo J, Cerezal J, Gonzalez-Aragoneses F, Novoa N, Sanchez-Palencia A: Prognostic value of chronic obstructive pulmonary disease in 2994 cases of lung cancer. Eur J Cardiothorac Surg 2005, 27(1):8-13.
• [5]Turner MC, Chen Y, Krewski D, Calle EE, Thun MJ: Chronic obstructive pulmonary disease is associated with lung cancer mortality in a prospective study of never smokers. Am J Respir Crit Care Med 2007, 176(3):285-290.
• [6]Raviv S, Hawkins KA, DeCamp MM Jr, Kalhan R: Lung cancer in chronic obstructive pulmonary disease: enhancing surgical options and outcomes. Am J Respir Crit Care Med 2011, 183(9):1138-1146.
• [7]Fabbri LM, Luppi F, Beghe B, Rabe KF: Complex chronic comorbidities of COPD. Eur Respir J 2008, 31(1):204-212.
• [8]Brunelli A, Charloux A, Bolliger CT, Rocco G, Sculier JP, Varela G, Licker M, Ferguson MK, Faivre-Finn C, Huber RM, et al.: ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy). Eur Respir J 2009, 34(1):17-41.
• [9]Loganathan RS, Stover DE, Shi W, Venkatraman E: Prevalence of COPD in women compared to men around the time of diagnosis of primary lung cancer. Chest 2006, 129(5):1305-1312.
• [10]Young RP, Hopkins RJ, Christmas T, Black PN, Metcalf P, Gamble GD: COPD prevalence is increased in lung cancer, independent of age, sex and smoking history. Eur Respir J 2009, 34(2):380-386.
• [11]Mitsudomi T, Kosaka T, Endoh H, Horio Y, Hida T, Mori S, Hatooka S, Shinoda M, Takahashi T, Yatabe Y: Mutations of the epidermal growth factor receptor gene predict prolonged survival after gefitinib treatment in patients with non-small-cell lung cancer with postoperative recurrence. J Clin Oncol 2005, 23(11):2513-2520.
• [12]Matsuo K, Ito H, Yatabe Y, Hiraki A, Hirose K, Wakai K, Kosaka T, Suzuki T, Tajima K, Mitsudomi T: Risk factors differ for non-small-cell lung cancers with and without EGFR mutation: assessment of smoking and sex by a case-control study in Japanese. Cancer Sci 2007, 98(1):96-101.
• [13]Zhang J, Zhou JB, Lin XF, Wang Q, Bai CX, Hong QY: Prevalence of undiagnosed and undertreated chronic obstructive pulmonary disease in lung cancer population. Respirology 2013, 18(2):297-302.
• [14]Matsuo M, Hashimoto N, Usami N, Imaizumi K, Wakai K, Kawabe T, Yokoi K, Hasegawa Y: Inspiratory capacity as a preoperative assessment of patients undergoing thoracic surgery. Interact Cardiovasc Thorac Surg 2012, 14(5):560-564.
• [15]Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, Coates A, van der Grinten CP, Gustafsson P, Hankinson J, et al.: Interpretative strategies for lung function tests. Eur Respir J 2005, 26(5):948-968.
• [16]Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, Fukuchi Y, Jenkins C, Rodriguez-Roisin R, Van Weel C, et al.: Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2007, 176(6):532-555.
• [17]Detterbeck FC, Boffa DJ, Tanoue LT: The new lung cancer staging system. Chest 2009, 136(1):260-271.
• [18]Maeda R, Yoshida J, Ishii G, Hishida T, Nishimura M, Nagai K: The prognostic impact of cigarette smoking on patients with non-small cell lung cancer. J Thorac Oncol 2011, 6(4):735-742.
• [19]Rudin CM, Avila-Tang E, Harris CC, Herman JG, Hirsch FR, Pao W, Schwartz AG, Vahakangas KH, Samet JM: Lung cancer in never smokers: molecular profiles and therapeutic implications. Clin Cancer Res 2009, 15(18):5646-5661.
• [20]Matsuda A, Matsuda T, Shibata A, Katanoda K, Sobue T, Nishimoto H: Cancer incidence and incidence rates in Japan in 2007: a study of 21 population-based cancer registries for the monitoring of cancer incidence in Japan (MCIJ) project. Jpn J Clin Oncol 2013, 43(3):328-336.
• [21]Society AC: Cancer facts and figures 2013. 2013. http://www.cancer.org/Research/CancerFactsFigures/CancerFactsFigures/2013-cancer-facts-and-figures.pdf webcite
• [22]Haiman CA, Stram DO, Wilkens LR, Pike MC, Kolonel LN, Henderson BE, Le Marchand L: Ethnic and racial differences in the smoking-related risk of lung cancer. N Engl J Med 2006, 354(4):333-342.
• [23]de Torres JP, Marin JM, Casanova C, Cote C, Carrizo S, Cordoba-Lanus E, Baz-Davila R, Zulueta JJ, Aguirre-Jaime A, Saetta M, et al.: Lung cancer in patients with chronic obstructive pulmonary disease– incidence and predicting factors. Am J Respir Crit Care Med 2011, 184(8):913-919.
• [24]Okada M, Nishio W, Sakamoto T, Harada H, Uchino K, Tsubota N: Long-term survival and prognostic factors of five-year survivors with complete resection of non-small cell lung carcinoma. J Thorac Cardiovasc Surg 2003, 126(2):558-562.
• [25]Colice GL, Shafazand S, Griffin JP, Keenan R, Bolliger CT: Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest 2007, 132(3 Suppl):161S-177S.
• [26]Baldwin DR, White B, Schmidt-Hansen M, Champion AR, Melder AM: Diagnosis and treatment of lung cancer: summary of updated NICE guidance. Bmj 2011, 342:d2110.
• [27]Fukuchi Y, Nishimura M, Ichinose M, Adachi M, Nagai A, Kuriyama T, Takahashi K, Nishimura K, Ishioka S, Aizawa H, et al.: COPD in Japan: the Nippon COPD epidemiology study. Respirology 2004, 9(4):458-465.
• [28]Tashkin DP, Celli B, Decramer M, Liu D, Burkhart D, Cassino C, Kesten S: Bronchodilator responsiveness in patients with COPD. Eur Respir J 2008, 31(4):742-750.
• [29]Kobayashi S, Suzuki S, Niikawa H, Sugawara T, Yanai M: Preoperative use of inhaled tiotropium in lung cancer patients with untreated COPD. Respirology 2009, 14(5):675-679.
• [30]Bolukbas S, Eberlein M, Eckhoff J, Schirren J: Short-term effects of inhalative tiotropium/formoterol/budenoside versus tiotropium/formoterol in patients with newly diagnosed chronic obstructive pulmonary disease requiring surgery for lung cancer: a prospective randomized trial. Eur J Cardiothorac Surg 2011, 39(6):995-1000.