title: Impact of chronic obstructive pulmonary disease on postoperative recurrence in patients with resected non-small-cell lung cancer.
abstract: OBJECTIVE
  This study aimed to determine whether the severity of chronic obstructive pulmonary disease (COPD) affects recurrence-free survival in non-small-cell lung cancer (NSCLC) patients after surgical resection.
  
  
  METHODS
  A retrospective study was performed on 421 consecutive patients who had undergone lobectomy for NSCLC from January 2008 to June 2011. Classification of COPD severity was based on guidelines of the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Characteristics among the three subgroups were compared and recurrence-free survivals were analyzed.
  
  
  RESULTS
  A total of 172 patients were diagnosed with COPD (124 as GOLD-1, 46 as GOLD-2, and two as GOLD-3). The frequencies of recurrence were significantly higher in patients with higher COPD grades (P<0.001). Recurrence-free survival at 5 years was 78.1%, 70.4%, and 46.4% in non-COPD, mild COPD, and moderate/severe COPD groups, respectively (P<0.001). By univariate analysis, the age, sex, smoking history, COPD severity, tumor size, histology, and pathological stage were associated with recurrence-free survival. Multivariate analysis showed that older age, male, moderate/severe COPD, and advanced stage were independent risk factors associated with recurrence-free survival.
  
  
  CONCLUSIONS
  NSCLC patients with COPD are at high risk for postoperative recurrence, and moderate/severe COPD is an independent unfavorable prognostic factor.
authors.affiliation: Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China.
authors.forename: Guangliang
authors.initials: G
authors.lastname: Qiang
authors.affiliation: Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China.
authors.forename: Chaoyang
authors.initials: C
authors.lastname: Liang
authors.affiliation: Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China.
authors.forename: Fei
authors.initials: F
authors.lastname: Xiao
authors.affiliation: Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China.
authors.forename: Qiduo
authors.initials: Q
authors.lastname: Yu
authors.affiliation: Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China.
authors.forename: Huanshun
authors.initials: H
authors.lastname: Wen
authors.affiliation: Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China.
authors.forename: Zhiyi
authors.initials: Z
authors.lastname: Song
authors.affiliation: Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China.
authors.forename: Yanchu
authors.initials: Y
authors.lastname: Tian
authors.affiliation: Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China.
authors.forename: Bin
authors.initials: B
authors.lastname: Shi
authors.affiliation: Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China.
authors.forename: Yongqing
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China.
authors.forename: Deruo
authors.initials: D
authors.lastname: Liu
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000009:adverse effects* / Q000379:methods; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012720:Severity of Illness Index; D047368:Tumor Burden
keywords: lung neoplasms; prognosis; pulmonary function test; surgery