Combined pulmonary fibrosis and emphysema and idiopathic pulmonary fibrosis in non-small cell lung cancer: impact on survival and acute exacerbation
Abstract Background In non-small cell lung cancer (NSCLC) patients, concomitant idiopathic pulmonary fibrosis (IPF) and emphysema (CPFE) are independently related to poor survival. CPFE is a condition with features of both pulmonary fibrosis and emphysema. Here, we evaluated the effect of CPFE and I...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-10-01
|
| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12890-019-0951-2 |
| _version_ | 1818441917349756928 |
|---|---|
| author | Sung Woo Moon Moo Suk Park Young Sam Kim Joon Jang Jae Ho Lee Choon-Taek Lee Jin-Haeng Chung Hyo Sup Shim Kyung Won Lee Seung-Seob Kim Sang Hoon Lee Ho Il Yoon |
| author_facet | Sung Woo Moon Moo Suk Park Young Sam Kim Joon Jang Jae Ho Lee Choon-Taek Lee Jin-Haeng Chung Hyo Sup Shim Kyung Won Lee Seung-Seob Kim Sang Hoon Lee Ho Il Yoon |
| author_sort | Sung Woo Moon |
| collection | DOAJ |
| description | Abstract Background In non-small cell lung cancer (NSCLC) patients, concomitant idiopathic pulmonary fibrosis (IPF) and emphysema (CPFE) are independently related to poor survival. CPFE is a condition with features of both pulmonary fibrosis and emphysema. Here, we evaluated the effect of CPFE and IPF alone on the outcomes of NSCLC patients. Patients and methods We retrospectively evaluated 283 patients with CPFE or IPF who were diagnosed with NSCLC between November 2003 and February 2018 at two tertiary care hospitals in South Korea. Patients were classified into CPFE and IPF groups according to chest computed tomography findings. Results One-hundred-and-seven patients (37.8%; mean age: 70.1 years; men 97.2%) had CPFE. Compared with IPF patients, CPFE patients had a heavier smoking history; lower diffusing capacity of carbon monoxide (78.0% vs 64.8%, p < 0.001), and lower forced expiratory volume in 1 s. Of all patients with NSCLC, 71.7% overall died during the follow-up period; 71.6% died in the CPFE group and 72.0% in the IPF group. Multivariate logistic regression analysis showed that CPFE (odds ratio [OR]: 2.26, 95% confidence interval [CI]: 1.09–4.69; P = 0.029) was significantly correlated with acute exacerbations (AEs). In a Cox proportional hazards analysis, stage > III NSCLC, higher Eastern Cooperative Oncology Group performance status, and higher gender–age–physiology index score was related to higher mortality. However, CPFE was not related to a higher mortality rate in univariate (hazard ratio [HR]: 1.00; 95% CI: 0.75–1.32, P = 0.972) or multivariate analysis (HR: 0.89; 95% CI: 0.66–1.21, P = 0.466). Conclusions AE risk, but not all-cause mortality, was higher in patients with CPFE and NSCLC than in those with IPF and NSCLC. Physicians should be aware of the exaggerated risk of AE in patients with concomitant CPFE and NSCLC. |
| first_indexed | 2024-12-14T18:35:52Z |
| format | Article |
| id | doaj.art-322808078ba84ed39bb6378effd8f3ee |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-14T18:35:52Z |
| publishDate | 2019-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-322808078ba84ed39bb6378effd8f3ee2022-12-21T22:51:36ZengBMCBMC Pulmonary Medicine1471-24662019-10-011911810.1186/s12890-019-0951-2Combined pulmonary fibrosis and emphysema and idiopathic pulmonary fibrosis in non-small cell lung cancer: impact on survival and acute exacerbationSung Woo Moon0Moo Suk Park1Young Sam Kim2Joon Jang3Jae Ho Lee4Choon-Taek Lee5Jin-Haeng Chung6Hyo Sup Shim7Kyung Won Lee8Seung-Seob Kim9Sang Hoon Lee10Ho Il Yoon11Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of MedicineDivision of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of MedicineDivision of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of MedicineDivision of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang HospitalDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang HospitalDepartment of Radiology, Seoul national University Bundang HospitalDepartment of Pathology, Yonsei University College of MedicineDepartment of Radiology, Seoul national University Bundang HospitalDepartment of Radiology, Yonsei University College of MedicineDivision of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang HospitalAbstract Background In non-small cell lung cancer (NSCLC) patients, concomitant idiopathic pulmonary fibrosis (IPF) and emphysema (CPFE) are independently related to poor survival. CPFE is a condition with features of both pulmonary fibrosis and emphysema. Here, we evaluated the effect of CPFE and IPF alone on the outcomes of NSCLC patients. Patients and methods We retrospectively evaluated 283 patients with CPFE or IPF who were diagnosed with NSCLC between November 2003 and February 2018 at two tertiary care hospitals in South Korea. Patients were classified into CPFE and IPF groups according to chest computed tomography findings. Results One-hundred-and-seven patients (37.8%; mean age: 70.1 years; men 97.2%) had CPFE. Compared with IPF patients, CPFE patients had a heavier smoking history; lower diffusing capacity of carbon monoxide (78.0% vs 64.8%, p < 0.001), and lower forced expiratory volume in 1 s. Of all patients with NSCLC, 71.7% overall died during the follow-up period; 71.6% died in the CPFE group and 72.0% in the IPF group. Multivariate logistic regression analysis showed that CPFE (odds ratio [OR]: 2.26, 95% confidence interval [CI]: 1.09–4.69; P = 0.029) was significantly correlated with acute exacerbations (AEs). In a Cox proportional hazards analysis, stage > III NSCLC, higher Eastern Cooperative Oncology Group performance status, and higher gender–age–physiology index score was related to higher mortality. However, CPFE was not related to a higher mortality rate in univariate (hazard ratio [HR]: 1.00; 95% CI: 0.75–1.32, P = 0.972) or multivariate analysis (HR: 0.89; 95% CI: 0.66–1.21, P = 0.466). Conclusions AE risk, but not all-cause mortality, was higher in patients with CPFE and NSCLC than in those with IPF and NSCLC. Physicians should be aware of the exaggerated risk of AE in patients with concomitant CPFE and NSCLC.http://link.springer.com/article/10.1186/s12890-019-0951-2Acute exacerbationCombined pulmonary fibrosis and emphysema (CPFE)Idiopathic pulmonary fibrosisMortalityNon-small cell lung cancer |
| spellingShingle | Sung Woo Moon Moo Suk Park Young Sam Kim Joon Jang Jae Ho Lee Choon-Taek Lee Jin-Haeng Chung Hyo Sup Shim Kyung Won Lee Seung-Seob Kim Sang Hoon Lee Ho Il Yoon Combined pulmonary fibrosis and emphysema and idiopathic pulmonary fibrosis in non-small cell lung cancer: impact on survival and acute exacerbation BMC Pulmonary Medicine Acute exacerbation Combined pulmonary fibrosis and emphysema (CPFE) Idiopathic pulmonary fibrosis Mortality Non-small cell lung cancer |
| title | Combined pulmonary fibrosis and emphysema and idiopathic pulmonary fibrosis in non-small cell lung cancer: impact on survival and acute exacerbation |
| title_full | Combined pulmonary fibrosis and emphysema and idiopathic pulmonary fibrosis in non-small cell lung cancer: impact on survival and acute exacerbation |
| title_fullStr | Combined pulmonary fibrosis and emphysema and idiopathic pulmonary fibrosis in non-small cell lung cancer: impact on survival and acute exacerbation |
| title_full_unstemmed | Combined pulmonary fibrosis and emphysema and idiopathic pulmonary fibrosis in non-small cell lung cancer: impact on survival and acute exacerbation |
| title_short | Combined pulmonary fibrosis and emphysema and idiopathic pulmonary fibrosis in non-small cell lung cancer: impact on survival and acute exacerbation |
| title_sort | combined pulmonary fibrosis and emphysema and idiopathic pulmonary fibrosis in non small cell lung cancer impact on survival and acute exacerbation |
| topic | Acute exacerbation Combined pulmonary fibrosis and emphysema (CPFE) Idiopathic pulmonary fibrosis Mortality Non-small cell lung cancer |
| url | http://link.springer.com/article/10.1186/s12890-019-0951-2 |
| work_keys_str_mv | AT sungwoomoon combinedpulmonaryfibrosisandemphysemaandidiopathicpulmonaryfibrosisinnonsmallcelllungcancerimpactonsurvivalandacuteexacerbation AT moosukpark combinedpulmonaryfibrosisandemphysemaandidiopathicpulmonaryfibrosisinnonsmallcelllungcancerimpactonsurvivalandacuteexacerbation AT youngsamkim combinedpulmonaryfibrosisandemphysemaandidiopathicpulmonaryfibrosisinnonsmallcelllungcancerimpactonsurvivalandacuteexacerbation AT joonjang combinedpulmonaryfibrosisandemphysemaandidiopathicpulmonaryfibrosisinnonsmallcelllungcancerimpactonsurvivalandacuteexacerbation AT jaeholee combinedpulmonaryfibrosisandemphysemaandidiopathicpulmonaryfibrosisinnonsmallcelllungcancerimpactonsurvivalandacuteexacerbation AT choontaeklee combinedpulmonaryfibrosisandemphysemaandidiopathicpulmonaryfibrosisinnonsmallcelllungcancerimpactonsurvivalandacuteexacerbation AT jinhaengchung combinedpulmonaryfibrosisandemphysemaandidiopathicpulmonaryfibrosisinnonsmallcelllungcancerimpactonsurvivalandacuteexacerbation AT hyosupshim combinedpulmonaryfibrosisandemphysemaandidiopathicpulmonaryfibrosisinnonsmallcelllungcancerimpactonsurvivalandacuteexacerbation AT kyungwonlee combinedpulmonaryfibrosisandemphysemaandidiopathicpulmonaryfibrosisinnonsmallcelllungcancerimpactonsurvivalandacuteexacerbation AT seungseobkim combinedpulmonaryfibrosisandemphysemaandidiopathicpulmonaryfibrosisinnonsmallcelllungcancerimpactonsurvivalandacuteexacerbation AT sanghoonlee combinedpulmonaryfibrosisandemphysemaandidiopathicpulmonaryfibrosisinnonsmallcelllungcancerimpactonsurvivalandacuteexacerbation AT hoilyoon combinedpulmonaryfibrosisandemphysemaandidiopathicpulmonaryfibrosisinnonsmallcelllungcancerimpactonsurvivalandacuteexacerbation |