International expert consensus on diagnosis and treatment of lung cancer complicated by chronic obstructive pulmonary disease

Chengzhi Zhou^#¹, Yinyin Qin^#¹, Wei Zhao^#², Zhenyu Liang^#¹, Min Li^#³, Dan Liu^#⁴, Li Bai⁵, Yahong Chen⁶, Yan Chen⁷, Yuan Cheng⁸, Tianqing Chu⁹, Qian Chu¹⁰, Haiyi Deng¹, Yuchao Dong¹¹, Wenfeng Fang¹², Xiuhua Fu¹³, Beili Gao¹⁴, Yiping Han¹⁵, Yong He¹⁶, Qunying Hong¹⁷, Jie Hu¹⁷, Yi Hu¹⁸, Liyan Jiang⁹, Yang Jin¹⁹, Fen Lan²⁰, Qiang Li²¹, Shuben Li¹, Wen Li²², Yaqing Li²³, Wenhua Liang¹, Gen Lin²⁴, Xinqing Lin¹, Ming Liu¹, Xiaofang Liu²⁵, Xiaoju Liu²⁶, Zhefeng Liu²⁷, Tangfeng Lv²⁸, Chuanyong Mu²⁹, Ming Ouyang¹, Jianwen Qin³⁰, Shengxiang Ren³¹, Huanzhong Shi³², Minhua Shi³³, Chunxia Su³⁴, Jin Su³⁵, Dejun Sun³⁶, Yongchang Sun⁶, Huaping Tang³⁷, Huijuan Wang³⁸, Kai Wang²⁰, Ke Wang³⁹, Mengzhao Wang⁴⁰, Qi Wang⁴¹, Wei Wang⁴², Xiaoping Wang⁴³, Yuehong Wang⁴⁴, Zhijie Wang⁴⁵, Zirui Wang², Lin Wu⁴⁶, Di Wu⁴⁷, Baosong Xie⁴⁸, Min Xie⁴⁹, Xiaohong Xie¹, Zhanhong Xie¹, Shufeng Xu⁵⁰, Xiaoman Xu⁵¹, Xia Yang⁵², Yan Yin⁴², Zongyang Yu⁵³, Jian Zhang⁵⁴, Jianqing Zhang⁵⁵, Jing Zhang¹⁷, Xiaoju Zhang⁵⁶, Yingying Zhang⁵⁷, Diansheng Zhong⁵⁸, Qing Zhou⁵⁹, Xiangdong Zhou⁶⁰, Yanbin Zhou⁶¹, Bo Zhu⁶², Zhengfei Zhu⁶³, Chenxi Zou², Nanshan Zhong¹, Jianxing He¹, Chunxue Bai⁶⁴, Chengping Hu⁶⁵, Weimin Li⁶⁶, Yong Song⁶⁷, Jianying Zhou⁶⁸, Baohui Han⁶⁹, Janos Varga⁷⁰, Esther Barreiro⁷¹, Hye Yun Park⁷², Francesco Petrella^{73

74}, Yuichi Saito⁷⁵, Taichiro Goto⁷⁶, Hitoshi Igai⁷⁷, Sara Bravaccini⁷⁸, Michele Zanoni⁷⁸, Piergiorgio Solli⁷⁹, Satoshi Watanabe⁸⁰, Alfonso Fiorelli⁸¹, Takeo Nakada⁸², Yoshinobu Ichiki⁸³, Rossana Berardi⁸⁴, Nikolaos Tsoukalas⁸⁵, Nicolas Girard^{86

87}, Antonio Rossi⁸⁸, Antonio Passaro⁸⁹, Toyoaki Hida⁹⁰, Shiyue Li¹, Liang'an Chen², Rongchang Chen^{91

92}

Affiliations

¹ The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
² Department of Respiratory and Critical Care Medicine, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
³ Department of Respiratory Medicine, Xiangya Cancer Center, Xiangya Hospital, Central South University, Changsha, China.
⁴ Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.
⁵ Department of Respiratory Medicine, Xinqiao Hospital Army Medical University, Chongqing, China.
⁶ Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China.
⁷ Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, China.
⁸ Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China.
⁹ Department of Respiratory Medicine, Shanghai Chest Hospital, Jiaotong University, Shanghai, China.
¹⁰ Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
¹¹ Department of Pulmonary and Critical Care Medicine, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China.
¹² Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.
¹³ Division of Respiratory Diseases, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
¹⁴ Department of Respiratory, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
¹⁵ Department of Respiratory Medicine, Changhai Hospital, Second Military Medical University, Shanghai, China.
¹⁶ Department of Pulmonary and Critical Care Medicine, Daping Hospital, Army Medical University, Chongqing, China.
¹⁷ Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
¹⁸ Department of Medical Oncology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
¹⁹ Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
²⁰ Department of Respiratory Medicine, The Second Affiliated Hospital of Zhejiang University of Medicine, Hangzhou, China.
²¹ Department of Respiratory Medicine, Shanghai Dongfang Hospital, Shanghai, China.
²² Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
²³ Department of Internal Medicine, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China.
²⁴ Department of Thoracic Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou, China.
²⁵ Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
²⁶ Department of Gerontal Respiratory Medicine, The First Hospital of Lanzhou University, Lanzhou, China.
²⁷ Department of Oncology, General Hospital of Chinese PLA, Beijing, China.
²⁸ Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
²⁹ Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China.
³⁰ Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital, Tianjin, China.
³¹ Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, China.
³² Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
³³ Department of Respiratory Medicine, The Second Affiliated Hospital of Suzhou University, Suzhou, China.
³⁴ Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
³⁵ Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China.
³⁶ Department of Respiratory and Critical Care Medicine, Inner Mongolia Autonomous Region People's Hospital, Hohhot, China.
³⁷ Department of Respiratory Medicine, Qingdao Municipal Hospital, Qingdao, China.
³⁸ Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China.
³⁹ Department of Respiratory Medicine, The Second Hospital of Jilin University, Changchun, China.
⁴⁰ Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Beijing, China.
⁴¹ Department of Respiratory Medicine, The Second Affiliated Hospital of Dalian Medical University, Dalian, China.
⁴² Department of Pulmonary and Critical Care Medicine, the First Hospital of China Medical University, Shenyang, China.
⁴³ Department of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China.
⁴⁴ Department of Respiratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
⁴⁵ Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁴⁶ Thoracic Medicine Department II, Hunan Cancer Hospital, Changsha, China.
⁴⁷ Department of Respiratory Medicine, Shenzhen People's Hospital, Shenzhen, China.
⁴⁸ Department of Respiratory Medicine, Fujian Provincial Hospital, Fuzhou, China.
⁴⁹ Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁵⁰ Department of Respiratory and Critical Care Medicine, First Hospital of Qinhuangdao, Qinhuangdao, China.
⁵¹ Department of Respiratory Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
⁵² Department of Respiratory Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
⁵³ Department of Pulmonary and Critical Care Medicine, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, China.
⁵⁴ Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
⁵⁵ Second Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China.
⁵⁶ Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
⁵⁷ Department of Medical Oncology, Xiangya Hospital, Central South University, Changsha, China.
⁵⁸ Department of Medical Oncology, Tianjin Medical University General Hospital, Tianjin, China.
⁵⁹ Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
⁶⁰ Department of Respiratory Medicine, The First Affiliated Hospital of Army Medical University, Chongqing, China.
⁶¹ Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
⁶² Chongqing Key Laboratory of Immunotherapy, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
⁶³ Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
⁶⁴ Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
⁶⁵ Department of Pulmonary Medicine, Xiangya Hospital, Central South University, Changsha, China.
⁶⁶ Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China.
⁶⁷ Department of Respiratory and Critical Care Medicine, Jinling Hospital, Nanjing, China.
⁶⁸ Department of Respiratory Diseases, The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou, China.
⁶⁹ Department of Pulmonology, Shanghai Chest Hospital, Shanghai, China.
⁷⁰ Department of Pulmonology, Semmelweis University, Budapest, Hungary.
⁷¹ Pulmonology Department-Lung Cancer and Muscle Research Group, IMIM-Hospital del Mar, Parc de Salut Mar, Department of Medicine and Life Sciences (MELIS), Pompeu Fabra University (UPF), CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII) Barcelona, Spain.
⁷² Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
⁷³ Division of Thoracic Surgery, IRCCS European Institute of Oncology, Milan, Italy.
⁷⁴ Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.
⁷⁵ Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
⁷⁶ Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, Yamanashi, Japan.
⁷⁷ Department of General Thoracic Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan.
⁷⁸ IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.
⁷⁹ Department of Cardio-Thoracic Surgery and Hearth & Lung Transplantation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
⁸⁰ Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
⁸¹ Thoracic Surgery Unit, Universitàdella Campania Luigi Vanvitelli, Naples, Italy.
⁸² Division of Thoracic Surgery, Department of Surgery, the Jikei University School of Medicine, Tokyo, Japan.
⁸³ Department of General Thoracic Surgery, Saitama Medical University International Medical Center, Saitama, Japan.
⁸⁴ Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy.
⁸⁵ Department of Oncology, 401 General Military Hospital, Athens, Greece.
⁸⁶ Institut du Thorax Curie Montsouris, Institut Curie, Paris, France.
⁸⁷ Paris Saclay, UVSQ, Versailles, France.
⁸⁸ Oncology Center of Excellence, Therapeutic Science & Strategy Unit, IQVIA, Milan, Italy.
⁸⁹ Division of Thoracic Oncology, European Institute of Oncology IRCCS, Milan, Italy.
⁹⁰ Lung Cancer Center, Central Japan International Medical Center, Minokamo, Japan.
⁹¹ Shenzhen Institute of Respiratory Diseases, Shenzhen People's Hospital, Shenzhen, China.
⁹² Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

^# Contributed equally.

PMID: 37691866
PMCID: PMC10483081
DOI: 10.21037/tlcr-23-339

Review

International expert consensus on diagnosis and treatment of lung cancer complicated by chronic obstructive pulmonary disease

Chengzhi Zhou et al. Transl Lung Cancer Res. 2023.

. 2023 Aug 30;12(8):1661-1701.

doi: 10.21037/tlcr-23-339. Epub 2023 Aug 24.

Authors

Affiliations

¹ The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
² Department of Respiratory and Critical Care Medicine, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
³ Department of Respiratory Medicine, Xiangya Cancer Center, Xiangya Hospital, Central South University, Changsha, China.
⁴ Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.
⁵ Department of Respiratory Medicine, Xinqiao Hospital Army Medical University, Chongqing, China.
⁶ Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China.
⁷ Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, China.
⁸ Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China.
⁹ Department of Respiratory Medicine, Shanghai Chest Hospital, Jiaotong University, Shanghai, China.
¹⁰ Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
¹¹ Department of Pulmonary and Critical Care Medicine, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China.
¹² Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.
¹³ Division of Respiratory Diseases, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
¹⁴ Department of Respiratory, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
¹⁵ Department of Respiratory Medicine, Changhai Hospital, Second Military Medical University, Shanghai, China.
¹⁶ Department of Pulmonary and Critical Care Medicine, Daping Hospital, Army Medical University, Chongqing, China.
¹⁷ Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
¹⁸ Department of Medical Oncology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
¹⁹ Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
²⁰ Department of Respiratory Medicine, The Second Affiliated Hospital of Zhejiang University of Medicine, Hangzhou, China.
²¹ Department of Respiratory Medicine, Shanghai Dongfang Hospital, Shanghai, China.
²² Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
²³ Department of Internal Medicine, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China.
²⁴ Department of Thoracic Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou, China.
²⁵ Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
²⁶ Department of Gerontal Respiratory Medicine, The First Hospital of Lanzhou University, Lanzhou, China.
²⁷ Department of Oncology, General Hospital of Chinese PLA, Beijing, China.
²⁸ Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
²⁹ Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China.
³⁰ Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital, Tianjin, China.
³¹ Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, China.
³² Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
³³ Department of Respiratory Medicine, The Second Affiliated Hospital of Suzhou University, Suzhou, China.
³⁴ Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
³⁵ Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China.
³⁶ Department of Respiratory and Critical Care Medicine, Inner Mongolia Autonomous Region People's Hospital, Hohhot, China.
³⁷ Department of Respiratory Medicine, Qingdao Municipal Hospital, Qingdao, China.
³⁸ Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China.
³⁹ Department of Respiratory Medicine, The Second Hospital of Jilin University, Changchun, China.
⁴⁰ Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Beijing, China.
⁴¹ Department of Respiratory Medicine, The Second Affiliated Hospital of Dalian Medical University, Dalian, China.
⁴² Department of Pulmonary and Critical Care Medicine, the First Hospital of China Medical University, Shenyang, China.
⁴³ Department of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China.
⁴⁴ Department of Respiratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
⁴⁵ Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁴⁶ Thoracic Medicine Department II, Hunan Cancer Hospital, Changsha, China.
⁴⁷ Department of Respiratory Medicine, Shenzhen People's Hospital, Shenzhen, China.
⁴⁸ Department of Respiratory Medicine, Fujian Provincial Hospital, Fuzhou, China.
⁴⁹ Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁵⁰ Department of Respiratory and Critical Care Medicine, First Hospital of Qinhuangdao, Qinhuangdao, China.
⁵¹ Department of Respiratory Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
⁵² Department of Respiratory Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
⁵³ Department of Pulmonary and Critical Care Medicine, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, China.
⁵⁴ Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
⁵⁵ Second Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China.
⁵⁶ Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
⁵⁷ Department of Medical Oncology, Xiangya Hospital, Central South University, Changsha, China.
⁵⁸ Department of Medical Oncology, Tianjin Medical University General Hospital, Tianjin, China.
⁵⁹ Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
⁶⁰ Department of Respiratory Medicine, The First Affiliated Hospital of Army Medical University, Chongqing, China.
⁶¹ Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
⁶² Chongqing Key Laboratory of Immunotherapy, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
⁶³ Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
⁶⁴ Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
⁶⁵ Department of Pulmonary Medicine, Xiangya Hospital, Central South University, Changsha, China.
⁶⁶ Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China.
⁶⁷ Department of Respiratory and Critical Care Medicine, Jinling Hospital, Nanjing, China.
⁶⁸ Department of Respiratory Diseases, The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou, China.
⁶⁹ Department of Pulmonology, Shanghai Chest Hospital, Shanghai, China.
⁷⁰ Department of Pulmonology, Semmelweis University, Budapest, Hungary.
⁷¹ Pulmonology Department-Lung Cancer and Muscle Research Group, IMIM-Hospital del Mar, Parc de Salut Mar, Department of Medicine and Life Sciences (MELIS), Pompeu Fabra University (UPF), CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII) Barcelona, Spain.
⁷² Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
⁷³ Division of Thoracic Surgery, IRCCS European Institute of Oncology, Milan, Italy.
⁷⁴ Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.
⁷⁵ Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
⁷⁶ Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, Yamanashi, Japan.
⁷⁷ Department of General Thoracic Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan.
⁷⁸ IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.
⁷⁹ Department of Cardio-Thoracic Surgery and Hearth & Lung Transplantation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
⁸⁰ Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
⁸¹ Thoracic Surgery Unit, Universitàdella Campania Luigi Vanvitelli, Naples, Italy.
⁸² Division of Thoracic Surgery, Department of Surgery, the Jikei University School of Medicine, Tokyo, Japan.
⁸³ Department of General Thoracic Surgery, Saitama Medical University International Medical Center, Saitama, Japan.
⁸⁴ Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy.
⁸⁵ Department of Oncology, 401 General Military Hospital, Athens, Greece.
⁸⁶ Institut du Thorax Curie Montsouris, Institut Curie, Paris, France.
⁸⁷ Paris Saclay, UVSQ, Versailles, France.
⁸⁸ Oncology Center of Excellence, Therapeutic Science & Strategy Unit, IQVIA, Milan, Italy.
⁸⁹ Division of Thoracic Oncology, European Institute of Oncology IRCCS, Milan, Italy.
⁹⁰ Lung Cancer Center, Central Japan International Medical Center, Minokamo, Japan.
⁹¹ Shenzhen Institute of Respiratory Diseases, Shenzhen People's Hospital, Shenzhen, China.
⁹² Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

^# Contributed equally.

PMID: 37691866
PMCID: PMC10483081
DOI: 10.21037/tlcr-23-339

Abstract

Background: Lung cancer combined by chronic obstructive pulmonary disease (LC-COPD) is a common comorbidity and their interaction with each other poses significant clinical challenges. However, there is a lack of well-established consensus on the diagnosis and treatment of LC-COPD.

Methods: A panel of experts, comprising specialists in oncology, respiratory medicine, radiology, interventional medicine, and thoracic surgery, was convened. The panel was presented with a comprehensive review of the current evidence pertaining to LC-COPD. After thorough discussions, the panel reached a consensus on 17 recommendations with over 70% agreement in voting to enhance the management of LC-COPD and optimize the care of these patients.

Results: The 17 statements focused on pathogenic mechanisms (n=2), general strategies (n=4), and clinical application in COPD (n=2) and lung cancer (n=9) were developed and modified. These statements provide guidance on early screening and treatment selection of LC-COPD, the interplay of lung cancer and COPD on treatment, and considerations during treatment. This consensus also emphasizes patient-centered and personalized treatment in the management of LC-COPD.

Conclusions: The consensus highlights the need for concurrent treatment for both lung cancer and COPD in LC-COPD patients, while being mindful of the mutual influence of the two conditions on treatment and monitoring for adverse reactions.

Keywords: Lung cancer; chronic obstructive pulmonary disease (COPD); concurrent treatment.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tlcr.amegroups.com/article/view/10.21037/tlcr-23-339/coif). Yong Song serves as an Editor-in-Chief of Translational Lung Cancer Research from September 2020 to August 2022. RB reports payment from AZ, BI, NOVARTIS, EISAI, MSD, OTSUKA, LILLY, ROCHE, Amgen, GSK, Seagen, Pierre Fabre Italfarmaco, outside the present manuscript. Nicolas Girard reports receiving research grants or support from Abbvie, Amgen, AstraZeneca, Beigene, Boehringer Ingelheim, Bristol-Myers-Squibb, Daiichi-Sankyo, Eli-Lilly, Gilead, Hoffmann-La Roche, Janssen, LeoPharma, Merck, Merck Sharp & Dohme, Novartis, Sivan; receiving payment from Abbvie, Amgen, AstraZeneca, Beigene, Bristol Myers Squibb, Daiichi-Sankyo, Eli-Lilly, Gilead, Hoffmann - La Roche, Ipsen, Janssen, LeoPharma, Medtronic, Merck Sharp & Dohme, Novartis, Pierre Fabre, Pfizer, Sanofi, and Takeda; having participation on a data safety monitoring board for Roche; having leadership role in the International Thymic Malignancy Interest Group; and having employment of a family member with AstraZeneca. AP received consulting or advisory role from Roche/Genentech, Bristol Myers Squibb, AstraZeneca, MSD Oncology, Pfizer, Boehringer Ingelheim, Janssen, Novartis, Daiichi Sankyo Europe GmbH, Bayer; payment or honoraria for speakers’ bureau form AstraZeneca, Janssen, Boehringer Ingelheim, Daiichi Sankyo Europe GmbH, MSD Oncology. The other authors have no conflicts of interest to declare.

Figures

**Figure 1**
The selection process for surgical and transbronchial interventions for COPD. COPD, chronic obstructive pulmonary disease; BLVR, bronchoscopic lung volume reduction; EBV, endobronchial valve; LVRS, lung volume reduction surgery; LVRC, lung volume reduction coil; BTVA, transbronchoscopic thermal vapor ablation.

**Figure 2**
Perioperative risk assessment (283). The figure has been adapted with permission obtained. CPET, Cardio-pulmonary exercise testing; DLCO, diffusion capacity of carbon monoxide; FEV₁, forced expiratory volume in 1 second; ppo, predicted postoperative value; SCT, stair climbing test; SWT, shuttle walk test; VO2max, maximum oxygen consumption.

See this image and copyright information in PMC

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International expert consensus on diagnosis and treatment of lung cancer complicated by chronic obstructive pulmonary disease

Affiliations

International expert consensus on diagnosis and treatment of lung cancer complicated by chronic obstructive pulmonary disease

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

LinkOut - more resources

Full Text Sources