title: An analysis of the clinical features of lung cancer in patients with connective tissue diseases.
abstract: BACKGROUND
  Patients with connective tissue diseases (CTDs) are at increased risk for lung cancer (LC); interstitial lung disease (ILD) is a common form of organ dysfunction in cases of CTD. However, the influence of ILD on the treatment and prognosis in LC patients with CTD is unclear.
  
  
  METHODS
  Between January 2010 and December 2014, 27 patients among all patients with CTD at our institution were diagnosed with primary LC. We retrospectively analyzed the clinical features, treatment modalities, and outcomes of these patients, and evaluated the potential prognostic factors. Forty-four LC patients without CTD were also analyzed as a control cohort.
  
  
  RESULTS
  LC patients with CTD had a significantly higher incidence of ILD as a complication compared with those without CTD (52% and 14%, respectively). CTD-associated ILD (CTD-ILD) at diagnosis was associated with significantly worse survival in LC patients with CTD. Multivariate analysis demonstrated that the complication of CTD-ILD was an independent poor prognostic factor in LC patients with CTD. The incidence of acute exacerbation (AE) of CTD-ILD was 21% among LC patients with CTD, and all of these patients died despite intensive treatment including high-dose corticosteroids. The restrictions in curative therapy for LC due to the presence of ILD and AE of CTD-ILD were thought to be the major reasons for the poor outcome.
  
  
  CONCLUSIONS
  LC patients with CTD had a high prevalence of ILD, and the presence of CTD-ILD was significantly associated with poor prognosis.
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan. Electronic address: saijo@tokushima-u.ac.jp.
authors.forename: Atsuro
authors.initials: A
authors.lastname: Saijo
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan. Electronic address: mhoney@tokushima-u.ac.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Hanibuchi
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan. Electronic address: hgoto@tokushima-u.ac.jp.
authors.forename: Hisatsugu
authors.initials: H
authors.lastname: Goto
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan. Electronic address: yktoy@tokushima-u.ac.jp.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Toyoda
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan. Electronic address: tezuka.toshifumi@tokushima-u.ac.jp.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Tezuka
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan. Electronic address: yasuhiko@tokushima-u.ac.jp.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Nishioka
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003240:Connective Tissue Diseases / Q000150:complications*; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D017563:Lung Diseases, Interstitial / Q000453:epidemiology / Q000209:etiology; D008175:Lung Neoplasms / Q000209:etiology* / Q000401:mortality; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012306:Risk
keywords: Acute exacerbation; Connective tissue disease; Interstitial lung disease; Lung cancer