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Eur J Cardiothorac Surg 2005;27:8-13
© 2005 Elsevier Science NL

Prognostic value of chronic obstructive pulmonary disease in 2994 cases of lung cancer

Pneumology Service, Hospital Universitario 12 de Octubre, Crrta. Andalucia 5.4, 28041 Madrid, Spain

Received 16 June 2004; received in revised form 30 August 2004; accepted 6 September 2004.

^* Corresponding author. Tel./fax: +34 91 390 8492. (E-mail: lencuent{at}h12o.es).

Objective: Given the frequent association between chronic obstructive pulmonary disease (COPD) and lung cancer (LC), the objective of this paper is to analyse the prognosis of this comorbidity. Methods: Multicenter prospective study compiling 2994 consecutive cases of surgically treated LC (1993–1997), the population with non-small cell lung cancer and complete resection was selected for the prognostic study of COPD. COPD is defined when the FEV1/FVC is <0.7 (n=1370; 46%). Overall and conditional survivals (survival likelihood when alive at 2, 3 or 5 years after treatment) as well as the degree of severity (FEV1% percentiles) were calculated to establish prognosis. Results: Although the overall survival is similar whether or not COPD is present (Log-rank: 0.34), the conditional survival analysis is different in every stage at 60 months (Log-rank: 0.02) and different in stage pI at 24–36 months (Log-rank: 0.04). In LC (stage pI) with COPD, the presence of a worst pulmonary function (last FEV1% percentile vs first FEV1% percentile) is a bad prognostic factor (Log-rank: 0.002). Conclusions: The analysis of conditional survival at 24 months shows that COPD can be considered as a prognostic factor and that there is a clear relationship between the severity of the condition (FEV1%) and survival.

Key Words: Lung cancer • Chronic obstructive pulmonary disease • Prognosis • Conditional survival analysis • Comorbidity • Surgery

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