ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.
Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.
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Association Between Pulmonary Function Tests and Overall Survival in Patients with Lung Cancer
Session Title
TP123 - TP123 LUNG FUNCTION: FLOW, VOLUME, AND HETEROGENEITY
Abstract
A4609 - Association Between Pulmonary Function Tests and Overall Survival in Patients with Lung Cancer
Author Block: T. Zhai, D. C. Christiani; Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Rationale: Pulmonary function is a risk factor for all-cause mortality, and chronic obstructive lung disease (COPD) is linked to worse overall survival (OS) in lung cancer patients. Assessing lung function pre-operatively helps predict in-hospital perioperative mortality from lung cancer, but the predictive ability for long-term survival is unclear. Hence, we aimed to clarify the role of pre-therapeutic pulmonary function in predicting OS of lung cancer patients through: 1) assessing the association between each pulmonary function test (PFT) and OS; 2) comparing OS across the spirometry-defined Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages of COPD; and 3) meta-analysis of published data reporting the association between PFTs and OS. Methods: We conducted a retrospective analysis using data from the Boston Lung Cancer Study between 1992-2020 on 3817 lung cancer patients who were newly diagnosed at enrollment and had PFT performed before initiating lung cancer therapy. Data from each PFT were divided into quartiles and analyzed for association with OS in univariate and multivariate models. We also split lung cancer patients with COPD into different GOLD stages and studied OS for spirometry-determined COPD. Finally, we performed a systematic review and meta-analysis for pooled estimates of published data. Results: Among lung cancer patients in the analytical cohort with mean age 66.7 years, 48.9% were male, and 88.2% reported smoking. The overall 5-year survival rate was 51.5%. Lower quartiles of actual and predicted forced expiratory volume in 1 second, forced vital capacity, diffusing capacity for carbon monoxide, and peak expiratory flow rate were all significantly associated with worse OS in a dose-response relationship across univariate and multivariate models. Median survival was 73.6 months (95% CI: 66.2–83.4 months) for patients without COPD, and 68.4 months (95% CI: 53.1–73.8 months) in GOLD stage 1, 51.4 months (95% CI: 46.6–58.0 months) in stage 2, 34.2 months (95% CI: 26.2–43.5 months) in stage 3, and 26.7 months (95% CI: 13.9–41.5 months) in stage 4. Meta-analysis showed a pooled hazard ratio of 1.48 (95% CI: 1.35–1.61) comparing PFTs in the lower category to the higher category. Conclusions: Lung cancer patients with poor pulmonary function at diagnosis have worse OS. Improvement in lung function before initiating lung cancer therapy could provide a long-term survival benefit.
Author Block: T. Zhai, D. C. Christiani; Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Rationale: Pulmonary function is a risk factor for all-cause mortality, and chronic obstructive lung disease (COPD) is linked to worse overall survival (OS) in lung cancer patients. Assessing lung function pre-operatively helps predict in-hospital perioperative mortality from lung cancer, but the predictive ability for long-term survival is unclear. Hence, we aimed to clarify the role of pre-therapeutic pulmonary function in predicting OS of lung cancer patients through: 1) assessing the association between each pulmonary function test (PFT) and OS; 2) comparing OS across the spirometry-defined Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages of COPD; and 3) meta-analysis of published data reporting the association between PFTs and OS. Methods: We conducted a retrospective analysis using data from the Boston Lung Cancer Study between 1992-2020 on 3817 lung cancer patients who were newly diagnosed at enrollment and had PFT performed before initiating lung cancer therapy. Data from each PFT were divided into quartiles and analyzed for association with OS in univariate and multivariate models. We also split lung cancer patients with COPD into different GOLD stages and studied OS for spirometry-determined COPD. Finally, we performed a systematic review and meta-analysis for pooled estimates of published data. Results: Among lung cancer patients in the analytical cohort with mean age 66.7 years, 48.9% were male, and 88.2% reported smoking. The overall 5-year survival rate was 51.5%. Lower quartiles of actual and predicted forced expiratory volume in 1 second, forced vital capacity, diffusing capacity for carbon monoxide, and peak expiratory flow rate were all significantly associated with worse OS in a dose-response relationship across univariate and multivariate models. Median survival was 73.6 months (95% CI: 66.2–83.4 months) for patients without COPD, and 68.4 months (95% CI: 53.1–73.8 months) in GOLD stage 1, 51.4 months (95% CI: 46.6–58.0 months) in stage 2, 34.2 months (95% CI: 26.2–43.5 months) in stage 3, and 26.7 months (95% CI: 13.9–41.5 months) in stage 4. Meta-analysis showed a pooled hazard ratio of 1.48 (95% CI: 1.35–1.61) comparing PFTs in the lower category to the higher category. Conclusions: Lung cancer patients with poor pulmonary function at diagnosis have worse OS. Improvement in lung function before initiating lung cancer therapy could provide a long-term survival benefit.
