F-098
IMPACT OF COMBINED PULMONARY FIBROSIS AND EMPHYSEMA ON SURGICAL COMPLICATIONS AND LONG-TERM SURVIVAL OF PATIENTS UNDERGOING SURGERY FOR NON-SMALL-CELL LUNG CANCER

Objectives: This study aimed to investigate postoperative morbidity and mortality, and the long-term survival for patients with lung cancer who have combined pulmonary fibrosis and emphysema (CPFE).

Methods: A retrospective chart review of 250 patients with lung cancer who underwent pulmonary resection at Tokyo Women's Medical University Yachiyo Medical Centre between 2008 and 2012 was undertaken. The patients were divided into four groups: Normal group, Emphysema group, interstitial pneumonia (IP) group, and CPFE group. The four groups were compared and long-term overall survivals were analysed. The definition of emphysema, IP and CPFE were low attenuation area (LAA) above 1 point at Goddard classification score without interstitial shadow, interstitial shadow without emphysema and the combination of LAA above 1 point at Goddard classification score in the upper field and basal pulmonary fibrosis on computed tomography, respectively.

Results: The numbers of the Normal, Emphysema, IP and CPFE groups were 124 (49.6%), 108 (43.2%), 7 (2.8%) and 11 patients (4.4%), respectively. The 5-year overall survivals were 77.1% in Normal group, 66.1% in Emphysema group, 40% in IP group and 25% in CPFE group (P = 0.0016). In the subset analysis focused on cancer stage I, the 5-year overall survival of CPFE group (n = 8, 20.8%) was lower than that of Emphysema group (71, 81.2%) (P < 0.0001). The frequency of death because of respiratory failure was significantly different among the four groups (P = 0.0005) and patients from the CPFE more likely died from respiratory failure. In the CPFE group, 3 patients (42.9%) died from acute excavation of IP or severe pneumonia.

Conclusions: CPFE have poorer prognosis than emphysema alone or normal lung patients. The preoperative intensive evaluation of CT was important and cancer therapy such as the operation method should be decided carefully in CPFE because of the risk of respiratory failure.

Disclosure: No significant relationships.