Is interstitial pneumonia in patients with collagen diseases a contraindication to lung cancer surgery?
OBJECTIVE
Lung cancer surgery can be dangerous in patients with interstitial pneumonia (IP) as acute exacerbation of the IP may prove fatal. It remains unclear if patients with collagen diseases (CD), who often suffer from IP, are also at increased risk during lung cancer surgery.


METHODS
We retrospectively examined 17 (3.1%) patients with CD among 545 patients who underwent surgery for lung cancer at our institution.


RESULTS
Nine patients with rheumatoid arthritis, five with systemic sclerosis, two with Sjögren's disease, and one with systemic lupus erythematosus were enrolled in this study. Eleven patients (65%) were taking corticosteroids at the time of surgery. Fourteen patients underwent lobectomy and lymph node dissection, and three patients with pStage IA lung cancer underwent pulmonary wedge resection. Pathologically, 11 (65%) patients had IP with various inflammatory cellular infiltrations, and three (18%) had honeycombing of the lung. Postoperatively, none of the patients suffered acute exacerbation of their IP.


CONCLUSIONS
Despite the high incidence of IP in patients with lung cancer and CD, our results suggest that CD is not a contraindication to the surgical resection of lung cancer.
Nakajima
Jun
J
Department of Cardiothoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Tokyo 113-8655, Japan.
Takamoto
Shinichi
S
Murakawa
Tomohiro
T
Fukami
Takeshi
T
Sano
Atsushi
A
D000368:Aged; D003095:Collagen Diseases / Q000150:complications / Q000188:drug therapy; D003240:Connective Tissue Diseases / Q000150:complications* / Q000188:drug therapy; D000075202:Contraindications; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000209:etiology*; D008175:Lung Neoplasms / Q000150:complications / Q000601:surgery*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D012189:Retrospective Studies; D016019:Survival Analysis
D005938:Glucocorticoids