Kang HS, Shin AY, Yeo CD, Kim JS, Kim YH, Kim JW, Lee SH. A lower level of forced expiratory volume in one second predicts the poor prognosis of small cell lung cancer.
J Thorac Dis 2018;
10:2179-2185. [PMID:
29850121 DOI:
10.21037/jtd.2018.03.121]
[Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background
The impact of impaired pulmonary function on the clinical outcome of small cell lung cancer (SCLC) has not been examined. The objectives of this study were to compare the clinical characteristics and prognosis of SCLC patients with and without impaired pulmonary function and investigate predictors related to the pulmonary function of mortality in SCLC patients.
Methods
This is a retrospective multicenter study performed between January 2011 and December 2015. In all, 170 SCLC patients that were treated with chemotherapy and/or radiotherapy and had a pulmonary function test (PFT) were enrolled. Patients were divided into the chronic obstructive pulmonary disease (COPD) group and the non-COPD group. The overall survival (OS) was compared and predictors of worse OS were analyzed.
Results
COPD was present in 54.7% of all SCLC patients. There were no differences in the clinical characteristics and treatment strategies between the COPD and non-COPD groups. OS (log-rank test, P=0.103) was not different between the COPD and non-COPD groups. In a multivariate analysis using a Cox regression model, extensive disease (ED) [hazard ratio (HR) =2.863; 95% CI: 1.787-4.587] and low forced expiratory volume in 1 second (FEV1) <80% (HR =1.854; 95% CI: 1.077-3.192) were independent risk factors for shorter survival. In a subgroup multivariate analysis, a FEV1 less than 80% (HR =5.631; P=0.018) was independently associated with poor OS in patients with ED.
Conclusions
A low FEV1, not COPD, was a predicting factor for poor treatment outcomes in SCLC patients.
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