Survival after surgery for pathologic stage IA non-small cell lung cancer associated with idiopathic pulmonary fibrosis

Abstract

Background: Many problems exist in regard to the treatment of lung cancer patients with idiopathic pulmonary fibrosis (IPF), but few reported studies have investigated the long-term prognosis after pulmonary resection in such patients. The purpose of the present study was to determine the postoperative survival of patients with pathologic stage IA non-small cell lung cancer (NSCLC) and IPF.

Methods: We retrospectively reviewed 350 patients with pathologic stage IA NSCLC who underwent pulmonary resections at our institution between September 1994 and December 2007. We analyzed and compared 28 of these patients, who had simultaneous lung cancer and IPF, with the remaining 322 lung cancer patients without IPF.

Results: The 5-year survival rates were 54.2% in pathologic stage IA lung cancer patients with IPF and 88.3% in those without IPF (p < 0.0001). Univariate analyses showed that age, sex, Brinkman Index, limited resection, operation time, adenocarcinoma, and IPF were significant prognostic factors for survival (p < 0.10). By multivariate analysis, however, only IPF was a significant prognostic factor for survival (p = 0.007). Propensity score-matching analysis confirmed that only IPF was significant prognostic factor (p = 0.043).

Conclusions: The 5-year survival rate of patients with pathologic stage IA NSCLC and IPF is 54.2%. IPF has independent, adverse effects on survival of pathologic stage IA NSCLC patients treated with pulmonary resection.