Rihong Zhai1, Xiaojin Yu1, Andrea Shafer2, John C Wain3, David C Christiani4. 1. Department of Environmental Health, Harvard School of Public Health. 2. Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA. 3. Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA. 4. Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address: dchris@hsph.harvard.edu.
Abstract
BACKGROUND: COPD is a recognized risk factor for lung cancer, but studies of coexisting COPD in relation to lung cancer outcomes are limited. We assessed the impact of COPD on overall survival (OS) and progression-free survival (PFS) in patients with early-stage non-small cell lung cancer (NSCLC). METHODS: Patients (N = 902) with early-stage (stage IA-IIB) NSCLC treated with surgical resection were retrospectively analyzed. The association of self-reported, physician-diagnosed COPD with survivals of NSCLC was assessed using the log-rank and Cox regression models, adjusting for age, sex, BMI, smoking, stages, and performance status. RESULTS: Among this cohort of patients with NSCLC, 330 cases had physician-diagnosed COPD, and 572 did not have COPD. The 5-year OS in patients with COPD (54.4%) was significantly lower (P = .0002) than that in patients without COPD (69.0%). The 5-year PFS rates for patients with COPD and without COPD were 50.1% and 60.6%, respectively (P = .007). Compared with patients without COPD, patients with COPD had increased risk of worse OS (adjusted hazard ratio [HRadj] = 1.41, P = .002) and PFS (HRadj = 1.67, P = .003). The associations between COPD and worse survival outcomes were stronger in men and in squamous cell carcinoma (SCC). CONCLUSIONS: Coexisting COPD is associated with worse survival outcomes in patients with early-stage NSCLC, particularly for men and for SCC.
BACKGROUND: COPD is a recognized risk factor for lung cancer, but studies of coexisting COPD in relation to lung cancer outcomes are limited. We assessed the impact of COPD on overall survival (OS) and progression-free survival (PFS) in patients with early-stage non-small cell lung cancer (NSCLC). METHODS:Patients (N = 902) with early-stage (stage IA-IIB) NSCLC treated with surgical resection were retrospectively analyzed. The association of self-reported, physician-diagnosed COPD with survivals of NSCLC was assessed using the log-rank and Cox regression models, adjusting for age, sex, BMI, smoking, stages, and performance status. RESULTS: Among this cohort of patients with NSCLC, 330 cases had physician-diagnosed COPD, and 572 did not have COPD. The 5-year OS in patients with COPD (54.4%) was significantly lower (P = .0002) than that in patients without COPD (69.0%). The 5-year PFS rates for patients with COPD and without COPD were 50.1% and 60.6%, respectively (P = .007). Compared with patients without COPD, patients with COPD had increased risk of worse OS (adjusted hazard ratio [HRadj] = 1.41, P = .002) and PFS (HRadj = 1.67, P = .003). The associations between COPD and worse survival outcomes were stronger in men and in squamous cell carcinoma (SCC). CONCLUSIONS: Coexisting COPD is associated with worse survival outcomes in patients with early-stage NSCLC, particularly for men and for SCC.
Authors: A Papi; G Casoni; G Caramori; I Guzzinati; P Boschetto; F Ravenna; N Calia; S Petruzzelli; L Corbetta; G Cavallesco; E Forini; M Saetta; A Ciaccia; L M Fabbri Journal: Thorax Date: 2004-08 Impact factor: 9.139
Authors: Wei Zhou; Sarada Gurubhagavatula; Geoffrey Liu; Sohee Park; Donna S Neuberg; John C Wain; Thomas J Lynch; Li Su; David C Christiani Journal: Clin Cancer Res Date: 2004-08-01 Impact factor: 12.531
Authors: Peng Wang; Dong Zhang; Xue-Guang Guo; Bao-Jun Sun; Xiang-Qun Fang; Ge-Ping Qu; Chang-Ting Liu Journal: Nan Fang Yi Ke Da Xue Xue Bao Date: 2017-07-20
Authors: Takashi Eguchi; Sarina Bains; Ming-Ching Lee; Kay See Tan; Boris Hristov; Daniel H Buitrago; Manjit S Bains; Robert J Downey; James Huang; James M Isbell; Bernard J Park; Valerie W Rusch; David R Jones; Prasad S Adusumilli Journal: J Clin Oncol Date: 2016-10-31 Impact factor: 44.544
Authors: Donald R Sullivan; Karen B Eden; Nathan F Dieckmann; Sara E Golden; Kelly C Vranas; Shannon M Nugent; Christopher G Slatore Journal: Lung Cancer Date: 2019-03-09 Impact factor: 5.705
Authors: Melissa K Accordino; Jason D Wright; Donna Buono; Alfred I Neugut; Dawn L Hershman Journal: J Oncol Pract Date: 2015-01-20 Impact factor: 3.840
Authors: C Matthew Kinsey; Raul San José Estépar; Jos van der Velden; Bernard F Cole; David C Christiani; George R Washko Journal: Cancer Epidemiol Biomarkers Prev Date: 2016-05-19 Impact factor: 4.254