Severity of chronic obstructive pulmonary disease and its relationship to lung cancer prognosis after surgical resection

Thorac Cardiovasc Surg. 2013 Mar;61(2):124-30. doi: 10.1055/s-0032-1304543. Epub 2012 Apr 25.


Objective: The purpose was to determine the rates of postoperative pulmonary complications, and to clarify the impact of COPD on long-term survival in lung cancer patients after surgical resection.

Methods: A retrospective chart review was performed on 1,461 patients who had undergone pulmonary resection for lung cancer from 1990 to 2005. Classification of COPD severity was based on spirometric guidelines of the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Postoperative complication rates among the four COPD groups were compared and long-term overall and disease-specific survivals were analyzed.

Results: The frequencies of all pulmonary complications in three COPD groups were higher than in the non-COPD group (all p < 0.05). Overall and disease-specific survivals were significantly worse in relation to higher COPD grades (all p ≤ 0.05). Significant prognostic factors were age, body mass index, positive smoking history, tumor size, pneumonectomy, pathologic stage, and COPD grade (p < 0.05).

Conclusion: Higher COPD grades had higher rates of postoperative pulmonary complications and poorer long-term survivals because of higher rates of cancer-related deaths.

MeSH terms

  • Aged
  • Chi-Square Distribution
  • Female
  • Humans
  • Japan / epidemiology
  • Kaplan-Meier Estimate
  • Lung Neoplasms / epidemiology
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Pneumonectomy* / adverse effects
  • Pneumonectomy* / mortality
  • Postoperative Complications / epidemiology
  • Postoperative Complications / mortality
  • Predictive Value of Tests
  • Prevalence
  • Proportional Hazards Models
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Pulmonary Disease, Chronic Obstructive / mortality
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Registries
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Spirometry
  • Time Factors
  • Treatment Outcome