COPD Severity as an Independent Predictor of Long-Term Survival in Operable Lung Cancer: A Retrospective Analysis from a High-Volume Thoracic Surgery Center.
Julia Zimmermann, Johannes Schön, Valentina Pfeiffer, Tim-Mathis Beutel, Annalena Felker, Elvira Stacher-Priehse, Fuad Damirov, Niels Reinmuth, Rudolf A Hatz, Christian P Schneider, Mircea Gabriel Stoleriu
{"title":"COPD Severity as an Independent Predictor of Long-Term Survival in Operable Lung Cancer: A Retrospective Analysis from a High-Volume Thoracic Surgery Center.","authors":"Julia Zimmermann, Johannes Schön, Valentina Pfeiffer, Tim-Mathis Beutel, Annalena Felker, Elvira Stacher-Priehse, Fuad Damirov, Niels Reinmuth, Rudolf A Hatz, Christian P Schneider, Mircea Gabriel Stoleriu","doi":"10.2147/COPD.S518084","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to identify predictors of long-term survival in patients with chronic obstructive pulmonary disease (COPD) undergoing anatomical resections for non-small cell lung cancer (NSCLC), with focus on COPD severity, to improve perioperative risk stratification and patient care.</p><p><strong>Patients and methods: </strong>This retrospective study included all patients with NSCLC and COPD undergoing anatomical resections at the Lung Tumor Center Munich between 2011 and 2020. COPD severity was classified by Global Initiative for Obstructive Lung Disease criteria: Group 1 (mild/moderate obstruction, COPD I-II) and Group 2 (severe obstruction, COPD III-IV). The relationship between COPD severity and perioperative parameters was analyzed using Kaplan-Meier and Cox proportional hazard model.</p><p><strong>Results: </strong>Of 1663 NSCLC patients undergoing anatomical resections, 476 (28.6%) patients with COPD I-IV (40.5% female, median age 67.28 [60.57; 73.27] years) were included. No significant differences were observed between groups in demographics, topography, TNM classification, histology of the primary tumor, and surgical approach. Group 2 experienced more frequently prolonged mechanical ventilation >2 days (p=0.016), air leaks >5 days (p = 0.020), and arrhythmias (p=0.012). Median overall survival (OS) was reduced in Group 2 (43.73 [30.14; 57.33] vs 85.30 [67.46; 103.14] months, p=0.001). Independent predictors of reduced OS included COPD III-IV (p<0.0001), pT<sub>3-4</sub> (p=0.007), pN<sub>1-2</sub> (p<0.0001), preoperative CRP >0.6 mg/dL (p=0.014) and VO<sub>2</sub>max <17 mL/min/kg (p=0.040). These predictors increased the risk of death by 1.6 [1.27-1.90], 1.3 [1.06-1.48], 2.1 [1.49-3.03], 1.6 [1.09-2.20] and 1. [1.02-2.00] fold, respectively.</p><p><strong>Conclusion: </strong>COPD severity independently predicts perioperative morbidity and long-term survival in operable NSCLC patients. Comprehensive assessment of COPD severity can help in identifying high-risk patients and optimizing perioperative care.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"3073-3091"},"PeriodicalIF":3.1000,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417699/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Chronic Obstructive Pulmonary Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/COPD.S518084","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: This study aims to identify predictors of long-term survival in patients with chronic obstructive pulmonary disease (COPD) undergoing anatomical resections for non-small cell lung cancer (NSCLC), with focus on COPD severity, to improve perioperative risk stratification and patient care.
Patients and methods: This retrospective study included all patients with NSCLC and COPD undergoing anatomical resections at the Lung Tumor Center Munich between 2011 and 2020. COPD severity was classified by Global Initiative for Obstructive Lung Disease criteria: Group 1 (mild/moderate obstruction, COPD I-II) and Group 2 (severe obstruction, COPD III-IV). The relationship between COPD severity and perioperative parameters was analyzed using Kaplan-Meier and Cox proportional hazard model.
Results: Of 1663 NSCLC patients undergoing anatomical resections, 476 (28.6%) patients with COPD I-IV (40.5% female, median age 67.28 [60.57; 73.27] years) were included. No significant differences were observed between groups in demographics, topography, TNM classification, histology of the primary tumor, and surgical approach. Group 2 experienced more frequently prolonged mechanical ventilation >2 days (p=0.016), air leaks >5 days (p = 0.020), and arrhythmias (p=0.012). Median overall survival (OS) was reduced in Group 2 (43.73 [30.14; 57.33] vs 85.30 [67.46; 103.14] months, p=0.001). Independent predictors of reduced OS included COPD III-IV (p<0.0001), pT3-4 (p=0.007), pN1-2 (p<0.0001), preoperative CRP >0.6 mg/dL (p=0.014) and VO2max <17 mL/min/kg (p=0.040). These predictors increased the risk of death by 1.6 [1.27-1.90], 1.3 [1.06-1.48], 2.1 [1.49-3.03], 1.6 [1.09-2.20] and 1. [1.02-2.00] fold, respectively.
Conclusion: COPD severity independently predicts perioperative morbidity and long-term survival in operable NSCLC patients. Comprehensive assessment of COPD severity can help in identifying high-risk patients and optimizing perioperative care.
期刊介绍：
An international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. Special focus will be given to the pathophysiological processes underlying the disease, intervention programs, patient focused education, and self management protocols. This journal is directed at specialists and healthcare professionals
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
