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Incidence and Risk Factors of Chronic Pulmonary Aspergillosis Development during Long-Term Follow-Up after Lung Cancer Surgery

Lung resection surgery for non-small-cell lung cancer (NSCLC) is reportedly a risk factor for developing chronic pulmonary aspergillosis (CPA). However, limited data are available regarding the development of CPA during long-term follow-up after lung cancer surgery. This study aimed to investigate t...

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Autores principales: Shin, Sun Hye, Kim, Bo-Guen, Kang, Jiyeon, Um, Sang-Won, Kim, Hojoong, Kim, Hong Kwan, Kim, Jhingook, Shim, Young Mog, Choi, Yong Soo, Jeong, Byeong-Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712970/
https://www.ncbi.nlm.nih.gov/pubmed/33182358
http://dx.doi.org/10.3390/jof6040271
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author Shin, Sun Hye
Kim, Bo-Guen
Kang, Jiyeon
Um, Sang-Won
Kim, Hojoong
Kim, Hong Kwan
Kim, Jhingook
Shim, Young Mog
Choi, Yong Soo
Jeong, Byeong-Ho
author_facet Shin, Sun Hye
Kim, Bo-Guen
Kang, Jiyeon
Um, Sang-Won
Kim, Hojoong
Kim, Hong Kwan
Kim, Jhingook
Shim, Young Mog
Choi, Yong Soo
Jeong, Byeong-Ho
author_sort Shin, Sun Hye
collection PubMed
description Lung resection surgery for non-small-cell lung cancer (NSCLC) is reportedly a risk factor for developing chronic pulmonary aspergillosis (CPA). However, limited data are available regarding the development of CPA during long-term follow-up after lung cancer surgery. This study aimed to investigate the cumulative incidence and clinical factors associated with CPA development after lung cancer surgery. We retrospectively analyzed 3423 patients with NSCLC who (1) underwent surgical resection and (2) did not have CPA at the time of surgery between January 2010 and December 2013. The diagnosis of CPA was based on clinical symptoms, serological or microbiological evidences, compatible radiological findings, and exclusion of alternative diagnoses. The cumulative incidence of CPA and overall survival (OS) were estimated using the Kaplan–Meier method, and a multivariable Cox proportional hazard analysis was performed to identify factors associated with CPA development. Patients were followed-up for a median of 5.83 years with a 72.3% 5-year OS rate. Fifty-six patients developed CPA at a median of 2.68 years after surgery, with cumulative incidences of 0.4%, 1.1%, 1.6%, and 3.5% at 1, 3, 5, and 10 years, respectively. Lower body mass index (BMI), smoking, underlying interstitial lung disease, thoracotomy, development of postoperative pulmonary complications 30 days after surgery, and treatment with both chemotherapy and radiotherapy were independently associated with CPA development. The cumulative incidence of CPA after surgery was 3.5% at 10 years and showed a steadily increasing trend during long-term follow-up. Therefore, increased awareness regarding CPA development is needed especially in patients with risk factors.
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spelling pubmed-77129702020-12-04 Incidence and Risk Factors of Chronic Pulmonary Aspergillosis Development during Long-Term Follow-Up after Lung Cancer Surgery Shin, Sun Hye Kim, Bo-Guen Kang, Jiyeon Um, Sang-Won Kim, Hojoong Kim, Hong Kwan Kim, Jhingook Shim, Young Mog Choi, Yong Soo Jeong, Byeong-Ho J Fungi (Basel) Article Lung resection surgery for non-small-cell lung cancer (NSCLC) is reportedly a risk factor for developing chronic pulmonary aspergillosis (CPA). However, limited data are available regarding the development of CPA during long-term follow-up after lung cancer surgery. This study aimed to investigate the cumulative incidence and clinical factors associated with CPA development after lung cancer surgery. We retrospectively analyzed 3423 patients with NSCLC who (1) underwent surgical resection and (2) did not have CPA at the time of surgery between January 2010 and December 2013. The diagnosis of CPA was based on clinical symptoms, serological or microbiological evidences, compatible radiological findings, and exclusion of alternative diagnoses. The cumulative incidence of CPA and overall survival (OS) were estimated using the Kaplan–Meier method, and a multivariable Cox proportional hazard analysis was performed to identify factors associated with CPA development. Patients were followed-up for a median of 5.83 years with a 72.3% 5-year OS rate. Fifty-six patients developed CPA at a median of 2.68 years after surgery, with cumulative incidences of 0.4%, 1.1%, 1.6%, and 3.5% at 1, 3, 5, and 10 years, respectively. Lower body mass index (BMI), smoking, underlying interstitial lung disease, thoracotomy, development of postoperative pulmonary complications 30 days after surgery, and treatment with both chemotherapy and radiotherapy were independently associated with CPA development. The cumulative incidence of CPA after surgery was 3.5% at 10 years and showed a steadily increasing trend during long-term follow-up. Therefore, increased awareness regarding CPA development is needed especially in patients with risk factors. MDPI 2020-11-09 /pmc/articles/PMC7712970/ /pubmed/33182358 http://dx.doi.org/10.3390/jof6040271 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Shin, Sun Hye
Kim, Bo-Guen
Kang, Jiyeon
Um, Sang-Won
Kim, Hojoong
Kim, Hong Kwan
Kim, Jhingook
Shim, Young Mog
Choi, Yong Soo
Jeong, Byeong-Ho
Incidence and Risk Factors of Chronic Pulmonary Aspergillosis Development during Long-Term Follow-Up after Lung Cancer Surgery
title Incidence and Risk Factors of Chronic Pulmonary Aspergillosis Development during Long-Term Follow-Up after Lung Cancer Surgery
title_full Incidence and Risk Factors of Chronic Pulmonary Aspergillosis Development during Long-Term Follow-Up after Lung Cancer Surgery
title_fullStr Incidence and Risk Factors of Chronic Pulmonary Aspergillosis Development during Long-Term Follow-Up after Lung Cancer Surgery
title_full_unstemmed Incidence and Risk Factors of Chronic Pulmonary Aspergillosis Development during Long-Term Follow-Up after Lung Cancer Surgery
title_short Incidence and Risk Factors of Chronic Pulmonary Aspergillosis Development during Long-Term Follow-Up after Lung Cancer Surgery
title_sort incidence and risk factors of chronic pulmonary aspergillosis development during long-term follow-up after lung cancer surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712970/
https://www.ncbi.nlm.nih.gov/pubmed/33182358
http://dx.doi.org/10.3390/jof6040271
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