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Review
. 2020 Jul;11(7):1784-1789.
doi: 10.1111/1759-7714.13445. Epub 2020 May 6.

Outcomes of lobectomy on pulmonary function for early stage non-small cell lung cancer (NSCLC) patients with chronic obstructive pulmonary disease (COPD)

Sen Wei  1 , Feng Chen  1 , Renwang Liu  1   2 , Dianxun Fu  3 , Yanye Wang  1 , Bo Zhang  1 , Dian Ren  1   2 , Fan Ren  1   2 , Zuoqing Song  1   2 , Jun Chen  1   2 , Song Xu  1   2
Affiliations
Review

Outcomes of lobectomy on pulmonary function for early stage non-small cell lung cancer (NSCLC) patients with chronic obstructive pulmonary disease (COPD)

Sen Wei et al. Thorac Cancer. 2020 Jul.

Abstract

Background: Lung cancer is the first cause of cancer mortality worldwide. Chronic obstructive pulmonary disease (COPD) is an independent risk factor for lung cancer. An epidemiological survey discovered that the presence of COPD increases the risk of lung cancer by 4.5-fold. Lobectomy is considered to be the standard surgical method for early stage non-small cell lung cancer (NSCLC). However, the influence of lobectomy on the loss of pulmonary function has not been fully investigated in NSCLC patients with COPD.

Methods: We searched the PubMed database using the following strategies: COPD and pulmonary function test (MeSH term) and lobectomy (MeSH term) from 01 January 1990 to 01 January 2019. We selected the articles of patients with COPD. A total of six studies, including 195 patients with COPD, provided lung function values before and after surgery.

Results: Five out of six studies focused on the short-term change of pulmonary function (within 3-6 months) after lobectomy, and the average loss of FEV1 was 0.11 L (range: -0.33-0.09 L). One study investigated the long-term change of pulmonary function (within 1-2 years) after lobectomy, and the average loss of FEV1 was 0.15 L (range: -0.29-0.05 L).

Conclusions: A short-term (3-6 months) loss of pulmonary function after operation is acceptable for lung cancer patients with COPD. However, there may be a high risk of postoperative complications in NSCLC patients with COPD. Therefore, surgical treatment needs to be carefully considered for these patients.

Keywords: COPD; lobectomy; non-small cell lung cancer; pulmonary function.

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Figures

Figure 1
Figure 1
Diagram of literature selection.
Figure 2
Figure 2
The changes of pulmonary function in lung cancer patients with COPD before and after operation. (a) The short‐term changes in FEV1. The study from Kushibe K and colleagues had four groups according to the location of lobectomy (formula image baseline value and formula image short‐term follow‐up). (b) The long‐term changes in FEV1. The study had two groups according to the difference value of preoperative FEV1 (formula image baseline value and formula image long‐term follow‐up).
See this image and copyright information in PMC

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