The prognostic impact of obstructive lung disease on survival of never smokers with resected non-small-cell lung cancer: a comparison with smokers

The Prognostic Long-Term Impact of Chronic Obstructive Pulmonary Disease and Postoperative Mucostasis in Patients with Curatively Resected Non-Small Cell Lung Cancer

Chronic obstructive pulmonary disease (COPD) serves as risk factor for the development of lung cancer and seems to have a prognostic impact after surgery for non-small cell lung cancer (NSCLC). The aim was to investigate the impact of COPD and postoperative mucostasis on the long-term survival after resected NSCLC. We retrospectively reviewed the data from 342 patients with curatively resected NSCLC. The prognostic long-term impact of COPD and postoperative mucostasis on overall survival (OS), recurrence free survival (RFS) and cancer specific survival (CSS) was calculated using univariable and multivariable Cox regression analyses. We found that 52.3% suffered from COPD and 25.4% had postoperative mucostasis. COPD was significantly more common among smokers (59.9%) compared with non-smokers (21.3%), (p < 0.001). There was a significant relationship between COPD and postoperative mucostasis (p = 0.006) and between smoking and mucostasis (p = 0.023). Patients with postoperative mucostasis had a significantly worse OS (p < 0.001), RFS (p = 0.009) and CSS (p = 0.008). The present analysis demonstrated that postoperative mucostasis, but not COPD, was associated with both worse short- and long-term outcomes for OS, RFS and CSS in curatively resected NSCLC.

The prognosis of non-small cell lung cancer combined with chronic obstructive pulmonary disease: A systematic review and meta-analysis

OBJECTIVE

To investigate the effect of non-small cell lung cancer (NSCLC) combined with Chronic Obstructive Pulmonary Disease (COPD) on prognosis, so as to provide help to clinical diagnosis and treatment.

METHODS

PubMed, Web of Science and the Medline were used to retrieve studies reported from 1950 to 2019. If the study reported the prognosis of COPD with NSCLC, the study was included and the relevant information was extracted and the data analyzed. The standard mean deviation (SMD) of 95% confidence interval was used in this meta-analysis.

RESULTS

A total of 851 data studies were reviewed for eligibility, eventually, 12 case-control studies were included in this systematic review and meta-analysis. The sample sizes for company's studies of NSCLC ranged from 85 to 10 378, with a total number of 14 164, including 2450 COPD and 9395 Non-COPD. Meta-analyses showed that concomitant COPD was associated with poorer OS compared with patients without COPD (Fixed: HR: 1.16; 95% CI: 1.08-1.25. Random: HR: 1.07; CI: 0.92-1.24), with a significant heterogeneity across studies (I²  = 45%, P = 0.04).

CONCLUSION

Our study showed that patients with combined COPD had an impact on the prognosis and survival rate of SCLC patients.