Surgical resection of lung cancer in patients with underlying interstitial lung disease.
BACKGROUND
The association between interstitial lung disease (ILD) and an increased risk of developing lung cancer has been reported. The goal of this retrospective study was to determine the outcome of lung cancer resection among patients with ILD.


METHODS
Between January 1979 and March 1999, 27 patients with both lung cancer and ILD were identified. Seven patients with poor pulmonary function tests or distant metastases underwent medical treatment and were excluded from this study. Twenty patients treated by surgical resection were analyzed.


RESULTS
Various types of ILD such as sarcoidosis (n = 7), idiopathic interstitial pneumonia (n = 4), histiocytosis X (n = 4), pneumoconiosis (n = 4), and amiodarone-induced ILD (n = 1) were observed. Tumors were located in the peripheral part of the lung in 16 cases. The most frequent tumor cell types were squamous and adenocarcinoma. The resections consisted of lobectomy (n = 16), bilobectomy (n = 1), and pneumonectomy (n = 3). Most cancers were stage I (n = 10) or II (n = 6). There was no postoperative death. The postoperative course was uneventful in 16 cases. The majority of patients (70%) did not experience respiratory insufficiency during the follow-up period. The actuarial 2-year and 5-year survival rates were, respectively, 83.5% and 66.4%.


CONCLUSIONS
In this series, the long-term survival of patients who had lung cancer resection appeared to be not affected by the association with ILD. This could be explained by an adequate preoperative selection based on pulmonary function tests and a preferential choice for lobectomies. Thus, surgical resection should be offered to properly selected patients with lung cancer and underlying ILD.
Martinod
Emmanuel
E
Department of Thoracic and Vascular Surgery, Hĵpital Avicenne, Assistance Publique-Hĵpitaux de Paris, Bobigny, France. emartinod@wanadoo.fr
Azorin
Jacques F
JF
Sadoun
Danielle
D
Destable
Marie-Dominique
MD
Le Toumelin
Philippe
P
Longchampt
Elisabeth
E
Kambouchner
Marianne
M
Guillevin
Loïc
L
Valeyre
Dominique
D
D000328:Adult; D000368:Aged; D001988:Bronchiolitis / Q000150:complications; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000150:complications*; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy; D017565:Sarcoidosis, Pulmonary / Q000150:complications; D016896:Treatment Outcome