Is interstitial pneumonia in patients with collagen diseases a contraindication to lung cancer surgery?

PURPOSE: Lung cancer surgery can be dangerous in patients with interstitial pneumonia (IP) as acute exacerbation of the IP may prove fatal. It remains unclear if patients with collagen diseases (CD), who often suffer from IP, are also at increased risk during lung cancer surgery.

METHODS

We retrospectively examined 17 (3.1%) patients with CD among 545 patients who underwent surgery for lung cancer at our institution.

RESULTS

Nine patients with rheumatoid arthritis, five with systemic sclerosis, two with Sjögren's disease, and one with systemic lupus erythematosus were enrolled in this study. Eleven patients (65%) were taking corticosteroids at the time of surgery. Fourteen patients underwent lobectomy and lymph node dissection, and three patients with pStage IA lung cancer underwent pulmonary wedge resection. Pathologically, 11 (65%) patients had IP with various inflammatory cellular infiltrations, and three (18%) had honeycombing of the lung. Postoperatively, none of the patients suffered acute exacerbation of their IP.

CONCLUSIONS

Despite the high incidence of IP in patients with lung cancer and CD, our results suggest that CD is not a contraindication to the surgical resection of lung cancer.