Mortality and lung function decline in patients who develop chronic pulmonary aspergillosis after lung cancer surgery

• Published in: BMC pulmonary medicine Vol. 22; no. 1; p. 436
• Main Authors: Kim, Bo-Guen, Choi, Yong Soo, Shin, Sun Hye, Lee, Kyungjong, Um, Sang-Won, Kim, Hojoong, Jeon, Yeong Jeong, Lee, Junghee, Cho, Jong Ho, Kim, Hong Kwan, Kim, Jhingook, Shim, Young Mog, Jeong, Byeong-Ho
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 22.11.2022; BioMed Central; BMC
• Subjects: Analysis; Antifungal agents; Aspergillosis; Cancer surgery; Cancer therapies; Care and treatment; Chronic pulmonary aspergillosis; Development and progression; Disease; Fungal infections; Humans; Lung; Lung cancer; Lung Neoplasms - surgery; Lungs; Mortality; Patients; Pulmonary Aspergillosis; Pulmonary function tests; Pulmonology; Respiratory function; Respiratory function tests; Retrospective Studies; Risk factors; Spirometry; Surgery; Vital Capacity; South Korea; United States > US; Chronic pulmonary aspergillosis; Lung cancer; Mortality; Surgery; Respiratory function tests
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-022-02253-y

Lung cancer surgery is reported as a risk factor for chronic pulmonary aspergillosis (CPA). However, limited data are available on its clinical impact. We aimed to determine the effect of developed CPA after lung cancer surgery on mortality and lung function decline. We retrospectively identified the development of CPA after lung cancer surgery between 2010 and 2016. The effect of CPA on mortality was evaluated using multivariable Cox proportional hazard analyses. The effect of CPA on lung function decline was evaluated using multiple linear regression analyses. During a median follow-up duration of 5.01 (IQR, 3.41-6.70) years in 6777 patients, 93 developed CPA at a median of 3.01 (IQR, 1.60-4.64) years. The development of CPA did not affect mortality in multivariable analysis. However, the decline in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV ) were greater in patients with CPA than in those without (FVC, - 71.0 [- 272.9 to - 19.4] vs. - 10.9 [- 82.6 to 57.9] mL/year, p < 0.001; FEV , - 52.9 [- 192.2 to 3.9] vs. - 20.0 [- 72.6 to 28.6] mL/year, p = 0.010). After adjusting for confounding factors, patients with CPA had greater FVC decline (β coefficient, - 103.6; 95% CI - 179.2 to - 27.9; p = 0.007) than those without CPA. However, the FEV decline (β coefficient, - 14.4; 95% CI - 72.1 to 43.4; p = 0.626) was not significantly different. Although the development of CPA after lung cancer surgery did not increase mortality, the impact on restrictive lung function deterioration was profound.