Significance of Pulmonary Artery Dilatation in Lung Cancer Patients With Chronic Obstructive Pulmonary Disease Who Underwent Pulmonary Resection

BACKGROUND:The significance of pulmonary artery (PA) diameter in patients with non-small cell lung cancer (NSCLC) and chronic obstructive pulmonary disease (COPD) who underwent pulmonary resection has not been elucidated. METHODS:Data of 357 patients with NSCLC and COPD who underwent pulmonary resection were retrospectively reviewed.The main PA diameter determined by preoperative computed tomography relative to the body surface area (PBR) was used as an index of PA dilation, and patients were divided into two groups using median values.The relationship between the PBR and short-and long-term outcomes was also analyzed. RESULTS:The mean age was 70.8 years old, and 82% of the patients were male.The median main PA diameter was 24 (range: 17-43) mm, and the median PBR was 14.5 (range: 10.4-28.6).A total of 276 patients (78%) underwent lobectomy or more, whereas 81 patients (22%) underwent sublobar resection.The postoperative complication rates did not differ between the low-and high-PBR groups (33% vs. 32%, p=0.91).The relapse-free survival (RFS) and overall survival (OS) rates of the low-PBR group were significantly better than those of the high-PBR group (5-year RFS: 76% vs. 59%, p=0.0003; 5-year OS: 88% vs. 72%, p=0.0010).A multivariable analysis identified high PBR as a poor prognostic factor for both RFS and OS.CONCLUSIONS: PA dilatation was associated with poor long-term outcomes and was an independent poor prognostic factor for both RFS and OS in NSCLC patients with COPD who underwent pulmonary resection.