Idiopathic Pulmonary Fibrosis in Patients with Early-Stage Non-Small-Cell Lung Cancer after Surgical Resection
Purpose. The outcomes of patients with both lung cancer and idiopathic pulmonary fibrosis (IPF) are unfavorable. Therapeutic interventions for lung cancer such as surgery can cause acute exacerbation of IPF (aeIPF). This study aimed to assess the frequency of IPF in a group of patients with early-stage non-small-cell lung cancer (NSCLC) and to report clinical characteristics and outcomes of this cohort of patients.
Methodology. This observational cohort retrospective study analyzed 641 pathological records of patients after surgical resection of early-stage NSCLC at University Clinic Golnik from May 2010 to April 2017. Pathological records of NSCLC with coexisting IPF were reviewed. CT scans and biopsy specimens for this group of patients were analyzed by a thoracic radiologist and pathologist, independently. We searched radiological and pathological features of usual interstitial pneumonia (UIP) pattern in this group of patients. We report the clinical characteristics and outcome of this cohort of patients.
Results. Out of 641 patients with early-stage NSCLC, only 13 (2.0 %) had histologically and radiologically proven coexisting UIP/IPF. Squamous cell carcinoma was the most common type of lung cancer (7/13 patients). The majority of tumors were small size (all being pT1 or pT2), stage I-II (11/13 patients), located in the lower lung lobes (11/13 patients). Almost all patients were current or ex-smokers (11/13 patients).
Conclusions. Frequency of UIP/IPF in surgically treated early stage NSCLC is rather low. Our observational study confirms that surgery might cause aeIPF with dismal outcome in this group of patients.
Key words: Early-Stage Non-Small-Cell Lung Cancer, Idiopathic Pulmonary Fibrosis, Acute exacerbation, Surgery, Radiotherapy