Operative indications for lung cancer with idiopathic pulmonary fibrosis

Background: idiopathic pulmonary fibrosis (IPF) is well known to be associated with lung cancer. However, surgical morbidity and mortality in lung cancer patients with IPF remains unclear. Methods: The data of patients who underwent surgery for non-small cell lung cancer were retrospectively reviewed. Results: Of the 1063 patients with lung cancer, 33 (3.1%) had IPF. Patients with IPF had significantly higher postoperative pulmonary morbidity and mortality than those without IPF (33.3 vs. 2.0%; 18.2 vs. 1.3%, respectively, p < 0.0001). Patients with IPF had a significantly higher incidence of postoperative acute lung injury/acute respiratory distress syndrome (ALI/ARDS) than those without IPF (27.3 vs. 1.3%, p < 0.0001). IPF patients with postoperative ALI/ARDS had a significantly lower preoperative %FVC than those without postoperative ALI/ARDS (74 +/- 9 vs. 103 +/- 14%, p < 0.0001). Conclusions: Lung cancer patients with IPF who have a low preoperative %FVC should be carefully assessed prior to any surgical intervention.