Skip to main content

Advertisement

SpringerLink
Log in

Prognostic impact of home oxygen therapy on patients with resected non-small-cell lung cancer with interstitial lung disease

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

Non-small-cell lung cancer (NSCLC) patients with interstitial lung disease (ILD) have a poor prognosis. The present study evaluated the prognostic impact of home oxygen therapy (HOT) in NSCLC patients with ILD.

Methods

Overall, 3099 consecutive patients underwent complete resection of stage IA to IIIA NSCLC at our institution between 2002 and 2016. ILD was diagnosed and categorized based on high-resolution computed tomography. The criteria for HOT included less than 90% resting oxygen saturation in the peripheral arteries and severe exertional dyspnea. We retrospectively compared the overall survival between ILD patients with and without HOT.

Results

ILD was observed in 150 (5%) patients. Seventeen (11%) patients needed HOT at discharge. The incidences of usual interstitial pneumonia (UIP) pattern (p = 0.03) and blood loss (p < 0.01) were significantly higher in the patients requiring HOT than in those without HOT. Significantly more patients developed complications (p = 0.04) in the HOT group than in the non-HOT group, with three (18%) having acute exacerbations. The 3-year overall survival rate was significantly lower in the HOT patients than in those without HOT (28% vs. 63%, p = 0.03).

Conclusions

Patients requiring postoperative HOT showed a significantly poorer prognosis after complete resection than those without HOT. Therefore, the indication for surgery should be investigated cautiously in order to prevent the need for postoperative HOT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sato T, Watanabe A, Kondo H, Kanzaki M, Okubo K, Yokoi K, et al. Long-term results and predictors of survival after surgical resection of patients with lung cancer and interstitial lung diseases. J Thorac Cardiovasc Surg. 2015;149(64–9):70.e1-2.

    Google Scholar 

  2. Bjoraker JA, Ryu JH, Edwin MK, Myers JL, Tazelaar HD, Schroeder DR, et al. Prognostic significance of histopathologic subsets in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 1998;157:199–203.

    Article  CAS  Google Scholar 

  3. Nicholson AG, Colby TV, du Bois RM, Hansell DM, Wells AU. The prognostic significance of the histologic pattern of interstitial pneumonia in patients presenting with the clinical entity of cryptogenic fibrosing alveolitis. Am J Respir Crit Care Med. 2000;162:2213–7.

    Article  CAS  Google Scholar 

  4. Raghu G, Collard HR, Egan JJ, Martinez FJ, Behr J, Brown KK, et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med. 2011;183:788–824.

    Article  Google Scholar 

  5. Rudd RM, Prescott RJ, Chalmers JC, Johnston ID. British Thoracic Society Study on cryptogenic fibrosing alveolitis: response to treatment and survival. Thorax. 2007;62:62–6.

    Article  Google Scholar 

  6. Bell EC, Cox NS, Goh N, Glaspole I, Westall GP, Watson A, et al. Oxygen therapy for interstitial lung disease: a systematic review. Eur Respir Rev. 2017;26:160080.

    Article  Google Scholar 

  7. Khor YH, Goh NSL, McDonald CF, Holland AE. Oxygen therapy for interstitial lung disease. A mismatch between patient expectations and experiences. Ann Am Thorac Soc. 2017;14:888–95.

    Article  Google Scholar 

  8. Saito Y, Kawai Y, Takahashi N, Ikeya T, Murai K, Kawabata Y, et al. Survival after surgery for pathologic stage IA non-small cell lung cancer associated with idiopathic pulmonary fibrosis. Ann Thorac Surg. 2011;92:1812–7.

    Article  Google Scholar 

  9. Sato S, Koike T, Hashimoto T, Ishikawa H, Okada A, Watanabe T, et al. Surgical outcomes of lung cancer patients with combined pulmonary fibrosis and emphysema and those with idiopathic pulmonary fibrosis without emphysema. Ann Thorac Cardiovasc Surg. 2016;22:216–23.

    Article  Google Scholar 

  10. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.

    Article  Google Scholar 

  11. Iwata T, Yoshida S, Nagato K, Nakajima T, Suzuki H, Tagawa T, et al. Experience with perioperative pirfenidone for lung cancer surgery in patients with idiopathic pulmonary fibrosis. Surg Today. 2015;45:1263–70.

    Article  Google Scholar 

  12. Sato T, Teramukai S, Kondo H, Watanabe A, Ebina M, Kishi K, et al. Impact and predictors of acute exacerbation of interstitial lung diseases after pulmonary resection for lung cancer. J Thorac Cardiovasc Surg. 2014;147(1604–11):e3.

    Google Scholar 

  13. Sekihara K, Aokage K, Miyoshi T, Tane K, Ishii G, Tsuboi M. Perioperative pirfenidone treatment as prophylaxis against acute exacerbation of idiopathic pulmonary fibrosis: a single-center analysis. Surg Today. 2020;50:905–11.

    Article  CAS  Google Scholar 

  14. Kitamura Y, Suzuki K, Teramukai S, Sonobe M, Toyooka S, Nakagawa Y, et al. Feasibility of pulmonary resection for lung cancer in patients with coronary artery disease or atrial fibrillation. Ann Thorac Surg. 2017;103:432–40.

    Article  Google Scholar 

  15. Yuan P, Cao JL, Huang S, Zhang C, Bao FC, Hu YJ, et al. Sublobar resection for pulmonary aspergilloma: a safe alternative to lobectomy. Ann Thorac Surg. 2017;103:1788–94.

    Article  Google Scholar 

  16. Miki K, Maekura R, Miki M, Kitada S, Yoshimura K, Tateishi Y, et al. Exertional acidotic responses in idiopathic pulmonary fibrosis: the mechanisms of exertional dyspnea. Respir Physiol Neurobiol. 2013;185:653–8.

    Article  Google Scholar 

  17. Bye PT, Anderson SD, Woolcock AJ, Young IH, Alison JA. Bicycle endurance performance of patients with interstitial lung disease breathing air and oxygen. Am Rev Respir Dis. 1982;126:1005–12.

    CAS  PubMed  Google Scholar 

  18. Harris-Eze AO, Sridhar G, Clemens RE, Gallagher CG, Marciniuk DD. Oxygen improves maximal exercise performance in interstitial lung disease. Am J Respir Crit Care Med. 1994;150:1616–22.

    Article  CAS  Google Scholar 

  19. Dowman LM, McDonald CF, Bozinovski S, Vlahos R, Gillies R, Pouniotis D, et al. Greater endurance capacity and improved dyspnoea with acute oxygen supplementation in idiopathic pulmonary fibrosis patients without resting hypoxaemia. Respirology. 2017;22:957–64.

    Article  Google Scholar 

  20. Sekihara K, Aokage K, Oki T, Omori T, Katsumata S, Ueda T, et al. Long-term survival after complete resection of non-small-cell lung cancer in patients with interstitial lung disease. Interact Cardiovasc Thorac Surg. 2018;26:638–43.

    Article  Google Scholar 

Download references

Acknowledgements

We would like to thank Editage (www.editage.com) for the English language editing.

Author information

Authors and Affiliations

  1. Division of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan

    Keigo Sekihara, Keiju Aokage, Hiroaki Oiwa, Tomohiro Miyoshi, Kenta Tane & Masahiro Tsuboi

  2. Course of Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan

    Keigo Sekihara & Genichiro Ishii

  3. Division of Diagnostic Radiology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan

    Takashi Hiyama

  4. Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, 6-5-1, Kashiwanoha, Kashiwa, Chiba, Japan

    Genichiro Ishii

Authors
  1. Keigo Sekihara
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Keiju Aokage
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takashi Hiyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroaki Oiwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tomohiro Miyoshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kenta Tane
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Genichiro Ishii
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Masahiro Tsuboi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Keigo Sekihara.

Ethics declarations

Conflict of interest

All authors have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sekihara, K., Aokage, K., Hiyama, T. et al. Prognostic impact of home oxygen therapy on patients with resected non-small-cell lung cancer with interstitial lung disease. Surg Today 51, 1036–1043 (2021). https://doi.org/10.1007/s00595-020-02186-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-020-02186-1

Search

Navigation