title: The impact of combined pulmonary fibrosis and chronic obstructive pulmonary disease on long-term survival after lung cancer surgery.
abstract: OBJECTIVE
  The purpose of this study was to determine the impact of pulmonary fibrosis (PF) on postoperative complications and on long-term survival after surgical resection in lung cancer patients with chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  A retrospective chart review was conducted of 380 patients with COPD who had undergone pulmonary resection for lung cancer at the University Hospital between 1990 and 2005. The definition of COPD was a preoperative forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ratio of less than 70%; PF was defined as obvious bilateral fibrous change in the lower lung fields, confirmed by computed tomography.
  
  
  RESULTS
  PF was present in 41 patients (10.8%) with COPD; the remaining 339 patients (89.2%) did not have PF. The preoperative FVC/FEV1 was significantly lower in the group of patients with PF than in the group without (p < 0.05). Acute lung injury and home oxygen therapy were significantly more common in the PF group; however, the 30-day mortality was similar between the groups. The cumulative survival at 3 and 5 years was 53.6 and 36.9%, respectively, in the PF group and 71.4 and 66.1%, respectively, in the non-PF group (p = 0.0009). Increased age, decreased body mass index, advanced pathologic stage, and the existence of PF were identified as independent risk factors for decreased survival.
  
  
  CONCLUSIONS
  PF is a risk factor for decreased survival after surgical treatment in lung cancer patients with COPD.
authors.affiliation: Department of Thoracic Surgery, Tokyo Women's Medical University, Yachiyo, Chiba, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Sekine
authors.affiliation: Department of Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sakairi
authors.affiliation: Department of Thoracic Surgery, Tokyo Women's Medical University, Yachiyo, Chiba, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Yoshino
authors.affiliation: Department of Thoracic Surgery, Tokyo Women's Medical University, Yachiyo, Chiba, Japan.
authors.forename: Eitetsu
authors.initials: E
authors.lastname: Koh
authors.affiliation: Department of Thoracic Surgery, Tokyo Women's Medical University, Yachiyo, Chiba, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hata
authors.affiliation: Department of Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Hidemi
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yoshino
mesh_terms: D000368:Aged; D005260:Female; D005541:Forced Expiratory Volume; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008168:Lung / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D011658:Pulmonary Fibrosis / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014797:Vital Capacity