Regional Emphysema Score Predicting Overall Survival, Quality of Life, and Pulmonary Function Recovery in Early-Stage Lung Cancer Patients

Jie Dai, Ming Liu, Stephen J. Swensen, Shawn M. Stoddard, Jason A. Wampfler, Andrew Harold Limper, Gening Jiang, Ping Yang

Research output: Contribution to journalArticle

Abstract

Introduction Pulmonary emphysema is a frequent comorbidity in lung cancer, but its role in tumor prognosis remains obscure. Our aim was to evaluate the impact of the regional emphysema score (RES) on a patient's overall survival, quality of life (QOL), and recovery of pulmonary function in stage I to II lung cancer. Methods Between 1997 and 2009, a total of 1073 patients were identified and divided into two surgical groups—cancer in the emphysematous (group 1 [n = 565]) and nonemphysematous (group 2 [n = 435]) regions—and one nonsurgical group (group 3 [n = 73]). RES was derived from the emphysematous region and categorized as mild (≤5%), moderate (6%–24%), or severe (25%–60%). Results In group 1, patients with a moderate or severe RES experienced slight decreases in postoperative forced expiratory volume in 1 second, but increases in the ratio of forced expiratory volume in 1 second to forced vital capacity compared with those with a mild RES (p < 0.01); however, this correlation was not observed in group 2. Posttreatment QOL was lower in patients with higher RESs in all groups, mainly owing to dyspnea (p < 0.05). Cox regression analysis revealed that patients with a higher RES had significantly poorer survival in both surgical groups, with adjusted hazard ratios of 1.41 and 1.43 for a moderate RES and 1.63 and 2.04 for a severe RES, respectively; however, this association was insignificant in the nonsurgical group (adjusted hazard ratio of 0.99 for a moderate or severe RES). Conclusions In surgically treated patients with cancer in the emphysematous region, RES is associated with postoperative changes in lung function. RES is also predictive of posttreatment QOL related to dyspnea in early-stage lung cancer. In both surgical groups, RES is an independent predictor of survival.

Original languageEnglish (US)
Pages (from-to)824-832
Number of pages9
JournalJournal of Thoracic Oncology
Volume12
Issue number5
DOIs
StatePublished - May 1 2017

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Recovery of Function
Emphysema
Lung Neoplasms
Quality of Life
Lung
Survival
Dyspnea
Pulmonary Emphysema
Vital Capacity
Forced Expiratory Volume
Comorbidity
Neoplasms
Regression Analysis

Keywords

  • Emphysema
  • Lung cancer
  • Pulmonary function
  • Quality of life
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Regional Emphysema Score Predicting Overall Survival, Quality of Life, and Pulmonary Function Recovery in Early-Stage Lung Cancer Patients. / Dai, Jie; Liu, Ming; Swensen, Stephen J.; Stoddard, Shawn M.; Wampfler, Jason A.; Limper, Andrew Harold; Jiang, Gening; Yang, Ping.

In: Journal of Thoracic Oncology, Vol. 12, No. 5, 01.05.2017, p. 824-832.

Research output: Contribution to journalArticle

Dai, Jie ; Liu, Ming ; Swensen, Stephen J. ; Stoddard, Shawn M. ; Wampfler, Jason A. ; Limper, Andrew Harold ; Jiang, Gening ; Yang, Ping. / Regional Emphysema Score Predicting Overall Survival, Quality of Life, and Pulmonary Function Recovery in Early-Stage Lung Cancer Patients. In: Journal of Thoracic Oncology. 2017 ; Vol. 12, No. 5. pp. 824-832.
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abstract = "Introduction Pulmonary emphysema is a frequent comorbidity in lung cancer, but its role in tumor prognosis remains obscure. Our aim was to evaluate the impact of the regional emphysema score (RES) on a patient's overall survival, quality of life (QOL), and recovery of pulmonary function in stage I to II lung cancer. Methods Between 1997 and 2009, a total of 1073 patients were identified and divided into two surgical groups—cancer in the emphysematous (group 1 [n = 565]) and nonemphysematous (group 2 [n = 435]) regions—and one nonsurgical group (group 3 [n = 73]). RES was derived from the emphysematous region and categorized as mild (≤5{\%}), moderate (6{\%}–24{\%}), or severe (25{\%}–60{\%}). Results In group 1, patients with a moderate or severe RES experienced slight decreases in postoperative forced expiratory volume in 1 second, but increases in the ratio of forced expiratory volume in 1 second to forced vital capacity compared with those with a mild RES (p < 0.01); however, this correlation was not observed in group 2. Posttreatment QOL was lower in patients with higher RESs in all groups, mainly owing to dyspnea (p < 0.05). Cox regression analysis revealed that patients with a higher RES had significantly poorer survival in both surgical groups, with adjusted hazard ratios of 1.41 and 1.43 for a moderate RES and 1.63 and 2.04 for a severe RES, respectively; however, this association was insignificant in the nonsurgical group (adjusted hazard ratio of 0.99 for a moderate or severe RES). Conclusions In surgically treated patients with cancer in the emphysematous region, RES is associated with postoperative changes in lung function. RES is also predictive of posttreatment QOL related to dyspnea in early-stage lung cancer. In both surgical groups, RES is an independent predictor of survival.",
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T1 - Regional Emphysema Score Predicting Overall Survival, Quality of Life, and Pulmonary Function Recovery in Early-Stage Lung Cancer Patients

AU - Dai, Jie

AU - Liu, Ming

AU - Swensen, Stephen J.

AU - Stoddard, Shawn M.

AU - Wampfler, Jason A.

AU - Limper, Andrew Harold

AU - Jiang, Gening

AU - Yang, Ping

PY - 2017/5/1

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N2 - Introduction Pulmonary emphysema is a frequent comorbidity in lung cancer, but its role in tumor prognosis remains obscure. Our aim was to evaluate the impact of the regional emphysema score (RES) on a patient's overall survival, quality of life (QOL), and recovery of pulmonary function in stage I to II lung cancer. Methods Between 1997 and 2009, a total of 1073 patients were identified and divided into two surgical groups—cancer in the emphysematous (group 1 [n = 565]) and nonemphysematous (group 2 [n = 435]) regions—and one nonsurgical group (group 3 [n = 73]). RES was derived from the emphysematous region and categorized as mild (≤5%), moderate (6%–24%), or severe (25%–60%). Results In group 1, patients with a moderate or severe RES experienced slight decreases in postoperative forced expiratory volume in 1 second, but increases in the ratio of forced expiratory volume in 1 second to forced vital capacity compared with those with a mild RES (p < 0.01); however, this correlation was not observed in group 2. Posttreatment QOL was lower in patients with higher RESs in all groups, mainly owing to dyspnea (p < 0.05). Cox regression analysis revealed that patients with a higher RES had significantly poorer survival in both surgical groups, with adjusted hazard ratios of 1.41 and 1.43 for a moderate RES and 1.63 and 2.04 for a severe RES, respectively; however, this association was insignificant in the nonsurgical group (adjusted hazard ratio of 0.99 for a moderate or severe RES). Conclusions In surgically treated patients with cancer in the emphysematous region, RES is associated with postoperative changes in lung function. RES is also predictive of posttreatment QOL related to dyspnea in early-stage lung cancer. In both surgical groups, RES is an independent predictor of survival.

AB - Introduction Pulmonary emphysema is a frequent comorbidity in lung cancer, but its role in tumor prognosis remains obscure. Our aim was to evaluate the impact of the regional emphysema score (RES) on a patient's overall survival, quality of life (QOL), and recovery of pulmonary function in stage I to II lung cancer. Methods Between 1997 and 2009, a total of 1073 patients were identified and divided into two surgical groups—cancer in the emphysematous (group 1 [n = 565]) and nonemphysematous (group 2 [n = 435]) regions—and one nonsurgical group (group 3 [n = 73]). RES was derived from the emphysematous region and categorized as mild (≤5%), moderate (6%–24%), or severe (25%–60%). Results In group 1, patients with a moderate or severe RES experienced slight decreases in postoperative forced expiratory volume in 1 second, but increases in the ratio of forced expiratory volume in 1 second to forced vital capacity compared with those with a mild RES (p < 0.01); however, this correlation was not observed in group 2. Posttreatment QOL was lower in patients with higher RESs in all groups, mainly owing to dyspnea (p < 0.05). Cox regression analysis revealed that patients with a higher RES had significantly poorer survival in both surgical groups, with adjusted hazard ratios of 1.41 and 1.43 for a moderate RES and 1.63 and 2.04 for a severe RES, respectively; however, this association was insignificant in the nonsurgical group (adjusted hazard ratio of 0.99 for a moderate or severe RES). Conclusions In surgically treated patients with cancer in the emphysematous region, RES is associated with postoperative changes in lung function. RES is also predictive of posttreatment QOL related to dyspnea in early-stage lung cancer. In both surgical groups, RES is an independent predictor of survival.

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KW - Lung cancer

KW - Pulmonary function

KW - Quality of life

KW - Survival

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