Diffusing capacity of the lung for carbon monoxide (DLCO) is a predictor of complications after resection for lung cancer. This study aimed to determine the association between DLCO and tumor aggressiveness and survival in clinical stage I non-small cell lung cancer (NSCLC) patients.
We retrospectively examined 437 consecutive patients with clinical stage IA NSCLC who underwent complete resection between January 2009 and December 2014 at our institution. Patients were divided into 2 groups according to preoperative DLCO value. Several potential prognostic factors including DLCO were analyzed with respect to outcomes.
The median follow-up periods after the operations were 39.0 months (1.0–99.0 months). Total 53 patients with 50% or less of DLCO and 384 patients with more than 50% of DLCO were compared. Patients with low DLCO were more male (77% vs 58%), higher age (73.5 ± 8.0 vs 66.7 ± 9.8), higher smoking history (93% vs 52%) compared with patients with high DLCO. The incidence of adenocarcinoma was low in patients with low DLCO (51% vs 84%), whereas the incidence of squamous cell carcinoma was high (40% vs 9%) compared to patients with high DLCO. 19% of adenocarcinoma patients with low DLCO were lepidic predominant, whereas 31% with high DLCO. The OS and DFS decreased to 68.3% and 63.7% at 5 years in patients with low DLCO, compared with 92.3% and 85.2% in patients with high DLCO (P
Preoperative DLCO correlated with tumor malignant grade and was an independent determinant of long-term survival in patients with clinical stage I NSCLC who were amenable to curative surgery.
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All authors have declared no conflicts of interest.