Lung Cancer Surgery in Patients with Chronic Obstructive Pulmonary Disease (COPD): Surgical Selection Challenges and Clinical Outcomes

Author(s): Georgia Hardavella*, Ioannis Karampinis, Panagiota Styliara, Ilias Kainis

Journal Name: Current Respiratory Medicine Reviews

Volume 15 , Issue 2 , 2019

Become EABM
Become Reviewer
Call for Editor

Graphical Abstract:


Health care systems worldwide are commonly burdened with COPD and lung cancer and subsequently much has been studied and learnt of the interdependence between these two clinical entities. Lung cancer surgical treatment options in patients with severe COPD remain a clinical challenge for the multidisciplinary team. Appropriate patient selection and prediction of postoperative pulmonary complications aid in surgical decision making and informed patient consent. In this review, we present an overview of surgical selection tools (lung function parameters, risk stratification for postoperative pulmonary complications) and lung cancer clinical outcomes (recurrence, survival) in patients with COPD undergoing lung cancer surgery.

Keywords: COPD, lung cancer, outcomes, postoperative pulmonary complications, surgical selection, CPET.

Brunelli A, Charloux A, Bolliger CT, et al. The European Respiratory Society and European Society of Thoracic Surgeons clinical guidelines for evaluating fitness for radical treatment (surgery and chemoradiotherapy) in patients with lung cancer. Eur J Cardiothorac Surg 2009; 36(1): 181-4.
Hardavella G, Spiro S. Lung cancer in COPD. Eur Respir Monogr 2013; 59: 174-88.
Licker MJ, Widikker I, Robert J, et al. Operative mortality and respiratory complications after lung resection for cancer: impact of chronic obstructive pulmonary disease and time trends. Ann Thorac Surg 2006; 81(5): 1830-7.
Mayne ST, Buenconsejo J, Janerich DT. Previous lung disease and risk of lung cancer among men and women nonsmokers. Am J Epidemiol 1999; 149(1): 13-20.
de Torres JP, Bastarrika G, Wisnivesky JP, et al. Assessing the relationship between lung cancer risk and emphysema detected on low-dose CT of the chest. Chest 2007; 132(6): 1932-8.
Jackson MW, Schubert LK, Jones B, et al. A Novel Lung Function Imaging Modality for Surgical Lung Cancer Evaluation International Journal of Radiation Oncology • Biology • Physics 2018; 96(2): S46.
Brunelli A, Kim AW, Berger KI, Addrizzo-Harris DJ. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013; 143(Suppl.5): e166S-90S.
Bedin DCC, Roberta Pulcheri Ramos R, Brito Vieira E, et al. Cardiopulmonary exercise test for risk assessment in lung resection surgery Eur Resp Journal 2018; 52: (OA5344)
Fortuna Gutierrez AM, Lenczewska M, Trujillo Reyes JC, et al. Cardiopulmonary Exercise Test parameters as predictors of postoperative morbidity in lung cancer surgery Eur Resp Journal 2018; 52: (PA2763)
Kiri VA, Soriano J, Visick G, Fabbri L. Recent trends in lung cancer and its association with COPD: An analysis using the UK GP Research Database. Prim Care Respir J 2010; 19(1): 57-61.
de Torres JP, Marín JM, Casanova C, et al. Lung cancer in patients with chronic obstructive pulmonary disease-- incidence and predicting factors. Am J Respir Crit Care Med 2011; 184(8): 913-9.
Yoshida Y, Kage H, Murakawa T, et al. Worse prognosis for stage IA lung cancer patients with smoking history and more severe chronic obstructive pulmonary disease. Ann Thorac Cardiovasc Surg 2015; 21(3): 194-200.
Canet J, Gallart L, Gomar C, et al. Prediction of postoperative pulmonary complications in a population-based surgical cohort. Anesthesiology 2010; 113(6): 1338-50.
Arozullah AM, Khuri SF, Henderson WG, Daley J. Development and validation of a multifactorial risk index for predicting postoperative pneumonia after major noncardiac surgery. Ann Intern Med 2001; 135(10): 847-57.
Arozullah AM, Daley J, Henderson WG, Khuri SF. Multifactorial risk index for predicting postoperative respiratory failure in men after major noncardiac surgery. Ann Surg 2000; 232(2): 242-53.
Durham AL, Adcock IM. The relationship between COPD and lung cancer. Lung Cancer 2015; 90(2): 121-7.
Sekine Y, Yamada Y, Chiyo M, et al. Association of chronic obstructive pulmonary disease and tumor recurrence in patients with stage IA lung cancer after complete resection. Ann Thorac Surg 2007; 84(3): 946-50.
Kiri VA, Soriano J, Visick G, Fabbri L. Recent trends in lung cancer and its association with COPD: an analysis using the UK GP Research Database. Prim Care Respir J Primary Care Respiratory Society UK 2010; 19(1): 57-61.
Shibazaki T, Odaka M, Noda Y, et al. Effect of comorbidities on long-term outcomes after thoracoscopic surgery for stage I non-small cell lung cancer patients with chronic obstructive pulmonary disease. J Thorac Dis 2018; 10(2): 909-19.
Tammemagi CM, Neslund-Dudas C, Simoff M, Kvale P. Impact of comorbidity on lung cancer survival. Int J Cancer 2003; 103(6): 792-802.
Lee SJ, Lee J, Park YS, et al. Impact of chronic obstructive pulmonary disease on the mortality of patients with non-small-cell lung cancer. J Thorac Oncol 2014; 9(6): 812-7.
Nakajima T, Sekine Y, Yamada Y, et al. Long-term surgical outcome in patients with lung cancer and coexisting severe COPD. Thorac Cardiovasc Surg 2009; 57(6): 339-42.
Abal Arca J, Parente Lamelas I, Almazán Ortega R, Blanco Pérez J, Toubes Navarro ME, Marcos Velázquez P. Cáncer de pulmón y EPOC: una asociación frecuente. Arch Bronconeumol 2009; 45(10): 502-7.
Izquierdo JL, Resano P, El Hachem A, Graziani D, Almonacid C, Sánchez IM. Impact of COPD in patients with lung cancer and advanced disease treated with chemotherapy and/or tyrosine kinase inhibitors. Int J Chron Obstruct Pulmon Dis 2014; 9: 1053-8.
Kondo R, Yoshida K, Eguchi T, et al. Clinical features of lung cancer in smokers with light and mild chronic obstructive pulmonary disease: a retrospective analysis of Japanese surgical cases. Eur J Cardiothorac Surg 2011; 40(6): 1439-43.
Mina N, Soubani AO, Cote ML, et al. The relationship between chronic obstructive pulmonary disease and lung cancer in African American patients. Clin Lung Cancer 2012; 13(2): 149-56.
Gullón JA, Suárez I, Medina A, Rubinos G, Fernández R, González I. Role of emphysema and airway obstruction in prognosis of lung cancer. Lung Cancer 2011; 71(2): 182-5.
Sekine Y, Suzuki H, Yamada Y, Koh E, Yoshino I. Severity of chronic obstructive pulmonary disease and its relationship to lung cancer prognosis after surgical resection. Thorac Cardiovasc Surg 2013; 61(2): 124-30.
Zhai R, Yu X, Shafer A, Wain JC, Christiani DC. The impact of coexisting COPD on survival of patients with early-stage non-small cell lung cancer undergoing surgical resection. Chest 2014; 145(2): 346-53.
Saji H, Miyazawa T, Sakai H, et al. Survival significance of coexisting chronic obstructive pulmonary disease in patients with early lung cancer after curative surgery. Thorac Cancer 2018; 9(1): 19-24.
Qiang G, Liang C, Xiao F, et al. Impact of chronic obstructive pulmonary disease on postoperative recurrence in patients with resected non-small-cell lung cancer. Int J Chron Obstruct Pulmon Dis 2015; 11: 43-9.

open access plus

Rights & PermissionsPrintExport Cite as

Article Details

Year: 2019
Published on: 10 December, 2019
Page: [140 - 146]
Pages: 7
DOI: 10.2174/1573398X15666190531104506

Article Metrics

PDF: 18