title: Effect of Perioperative Pirfenidone Treatment in Lung Cancer Patients With Idiopathic Pulmonary Fibrosis.
abstract: BACKGROUND
  Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is a life-threatening complication of lung cancer operation for patients with IPF, and no effective prophylaxis has ever been reported. In this study, we investigate the effect of perioperative treatment with an anti-IPF agent on reduction of the risk of developing AE-IPF.
  
  
  METHODS
  A consecutive series of 50 lung cancer patients with IPF who underwent operations at our institution from October 2006 to October 2014 was retrospectively investigated. Since September 2009, pirfenidone was orally administered to patients from 4 weeks before operation to 4 weeks after operation. Thirty-one patients received the perioperative pirfenidone treatment (PPT), and their clinical outcome was retrospectively compared with that of 19 patients who did not receive PPT.
  
  
  RESULTS
  No differences were found in age, smoking history, sex, vital capacity, KL-6, procedure, or risk score (10.5 ± 2.2 versus 11.2 ± 1.5) between the PPT and non-PPT groups. The incidence of AE-IPF for the PPT/non-PPT groups was 0.0%/10.5% within 30 postoperative days (p = 0.07) and 3.2%/21.1% within 90 postoperative days (p = 0.04), respectively. Logistic regression analysis showed a significant association between PPT and the incidence of AE-IPF within 30 (p = 0.045) and 90 (p = 0.04) postoperative days.
  
  
  CONCLUSIONS
  A prophylactic effect of PPT for postoperative AE-IPF in patients with lung cancer was suggested. Further confirmatory prospective studies should be considered for PPT.
authors.affiliation: Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Takekazu
authors.initials: T
authors.lastname: Iwata
authors.affiliation: Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Taiki
authors.initials: T
authors.lastname: Fujiwara
authors.affiliation: Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Wada
authors.affiliation: Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakajima
authors.affiliation: Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Hidemi
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan. Electronic address: iyoshino@faculty.chiba-u.jp.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yoshino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D018450:Disease Progression; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control*; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods*; D011013:Pneumonectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000188:drug therapy / Q000517:prevention & control*; D011728:Pyridones / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D011728:Pyridones; C093844:pirfenidone