Analysis Of The Effect Of COPD On Progression-free Survival Of Male Patients With Lung Cancer

Objective:COPD is an independent risk factor for lung cancer,and both diseases often coexist.Whether the presence of COPD affects survival in patients with lung cancer remains unclear.At present,most retrospective studies focus on the clinical features of COPD patients with lung cancer,such as pathogenesis,symptoms,lung cancer type,imaging findings,lung cancer staging,etc.There are few studies on the effect of COPD on the prognosis of lung cancer,and the conclusions are mixed.In order to clarify the clinical characteristics of COPD complicated with lung cancer and verify whether COPD is an independent risk factor affecting the prognosis of lung cancer,relevant cases were collected and divided into non-group and COPD group for study.Methods:Male patients admitted to the respiratory department and thoracic surgery department of Qingdao Municipal Hospital from January 2017 to December 2020 were selected for a case-control study.Among them,145 patients with normal lung function and no history of chronic bronchitis or emphysema were assigned to the non-COPD group,while 63 patients with a history of COPD were assigned to the COPD group.Subjects with complicated primary tumors in other sites and other benign lung diseases were excluded.Patients who did not receive antitumor therapy and regular evaluation after diagnosis of lung cancer were excluded.Cases were evaluated using the RECIST criteria,and disease progression was assessed by recording the examination date as the disease progression date.Complete response,partial response,and stable disease were assessed as not progressing,and the date of examination was also recorded.The date of the last chest CT review was collected for cases that had not progressed by the cutoff date.The general data of the two groups were compared by t-test and Pearsonχ~2 test.The Fisherχ~2 test was used for those groups with 0 frequency.Measurement data was expressed as mean ± standard deviation,while enumeration data was expressed as percentage.Kaplan-Meier survival curve was used to evaluate PFS between COPD group and non-COPD group,and log-rank test was used to evaluate the difference.Cox proportional risk regression model was used for multivariate analysis to evaluate the influence of COPD on lung cancer PFS.Univariate and multivariate Cox regression analyses were also performed for COPD group.Univariate and multivariate Cox regression analyses were also performed for COPD group.Results:1.The total number of cases studied was 208,including 63 patients(30%)in the COPD group.There were no significant differences in age,smoking index,stage at diagnosis and treatment between the two groups(P>0.05),and there were significant differences in PFS(P<0.05).The mean time to PFS was 16.72 months in the no-COPD group and 9.83 months in the COPD group.Although the difference in median PFS between the two groups was not statistically significant,PFS in the COPD group was lower than that in the no-COPD group according to the survival curve.2.In the overall analysis of lung cancer,COPD was not a risk factor affecting the progression of lung cancer,and only stage III-IV lung cancer and chemotherapy or targeted therapy withwithout surgery was an independent risk factor for the progression of the disease.The risk of disease progression was 4.499 times higher in patients with stage III+IV than in patients with stage I+II.The risk of disease progression with chemotherapy alone or with targeted therapy was 3.714-fold and 11.479 fold,respectively,compared with that with surgery.3.Risk factor analysis of COPD group showed that smoking index,clinical stage and treatment method all had an impact on PFS of lung cancer patients with COPD,but only treatment method was an independent risk factor for short-term PFS.The risk of disease progression was 3.912 and 9.067 times higher with chemotherapy alone and targeted therapy alone than with surgery,respectively.Patients receiving combination therapy did not increase the risk of disease progression in lung cancer patients with COPD.Conclusion:1.PFS in COPD group was significantly shorter than that in non-COPD group,COPD is not an independent risk factor for the progression of lung cancer patients.2..Single nonsurgical treatment is an independent risk factor for disease progression in lung cancer patients with COPD.