J Korean Med Sci.  2010 Aug;25(8):1146-1151. 10.3346/jkms.2010.25.8.1146.

Emphysema as a Risk Factor for the Outcome of Surgical Resection of Lung Cancer

• Lee SA
• Sun JS
• Park JH
• Park KJ
• Lee SS
• Choi H
• Sheen SS
• Chung WY
• Lee KS
• Park KJ
• Hwang SC

• KMID: 1714034
• DOI: http://doi.org/10.3346/jkms.2010.25.8.1146

Abstract

It is unclear whether emphysema, regardless of airflow limitation, is a predictive factor associated with survival after lung cancer resection. Therefore, we investigated whether emphysema was a risk factor associated with the outcome after resection for lung cancer. This study enrolled 237 patients with non small cell lung cancer with stage I or II who had surgical removal. Patient outcome was analyzed based on emphysema. Emphysema was found in 43.4% of all patients. Patients with emphysema were predominantly men and smokers, and had a lower body mass index than the patients without emphysema. The patients without emphysema (n=133) survived longer (mean 51.2+/-3.0 vs. 40.6+/-3.1 months, P=0.042) than those with emphysema (n=104). The univariate analysis showed a younger age, higher FEV1/FVC, higher body mass index, cancer stage I, and a lower emphysema score were significant predictors of better survival. The multivariate analysis revealed a younger age, higher body mass index, and cancer stage I were independent parameters associated with better survival, however, emphysema was not. This study suggests that unfavorable outcomes after surgical resection of lung cancer should not be attributed to emphysema itself.

Keyword

Non-Small-Cell Lung Carcinoma; Emphysema; Surgery

MeSH Terms

Age Factors
Aged
Body Mass Index
Carcinoma, Non-Small-Cell Lung/complications/mortality/*surgery
Emphysema/*complications
Female
Humans
Lung Neoplasms/complications/mortality/*surgery
Male
Middle Aged
Neoplasm Staging
Predictive Value of Tests
Risk Factors
Smoking
Survival Rate

Figure

• 

  Fig. 1 Kaplan-Meier curves for Survival of total Patients depending on the presence of emphysema (○emphysema (n=104), mean survival, 40.6±3.1 months; •non emphysema (n=133) mean survival, 51.2±3.0 months, P=0.042).

• 

  Fig. 2 Kaplan-Meier curves for survival of NSCLC patients with stage I depending on the presence of emphysema (○emphysema (n=62), mean survival, 44.0±3.9 months; •non emphysema (n=97), mean survival, 57.9±3.1 months, P=0.036).

• 

  Fig. 3 Survival of NSCLC Patients based on the degree of emphysema (Mean survival period of each group; Emp 0 (Grade 0, n=133), 51.2±3.0 months; Emp 1 (Grade 1, n=19), 41.7±7.6 months; Emp 2 (Grade 2, n=21), 41.1±5.7 months; Emp 3 (Grade 3, n=20), 44.2±6.8 months; Emp 4 (Grade 4, n=20), 26.3±7.1, P=0.07). Emp, emphysema.

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