WCLC 2025 - Posters & ePosters-EP.08.02 A Study of Patients With Lung Cancer Complicated With Ipf Who Underwent Partial Pulmonary Resection

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This retrospective single-center study analyzed six patients with idiopathic pulmonary fibrosis (IPF) who underwent video-assisted thoracoscopic surgery (VATS) wedge resection for lung cancer between 2015 and 2017. IPF patients face a high lung cancer risk, and surgical treatment is complicated by poor lung reserve and the risk of postoperative acute exacerbation (AE). Wedge resection, being less invasive, may be the only feasible option for high-risk patients, such as those with hypoxemia or prior lung resections.<br /><br />Patient median age was 73.5 years, all underwent VATS wedge resection, and no postoperative AE occurred. Five-year overall survival (OS) was 50%, higher than previously reported rates for IPF lung cancer patients (typically around 33.2% for wedge resection). Notably, patients with stage IA lung cancer showed 100% 5-year OS in this cohort. However, local recurrence at the surgical margin was observed in two patients, reflecting the difficulty of achieving clear margins in fibrotic lung tissue. Half the patients developed secondary lung cancers within five years but survived beyond seven years due to preserved lung function enabling salvage treatments.<br /><br />The study emphasizes that wedge resection minimizes surgical stress, preserves pulmonary reserve, and lowers AE risk compared to segmentectomy or lobectomy, aided by lower JACS risk scores. These factors likely contributed to improved survival outcomes. Nevertheless, risks of local recurrence remain, requiring careful preoperative planning and patient selection.<br /><br />Limitations include the small sample size, retrospective design, and lack of control groups. Larger multicenter studies are necessary to optimize patient selection and validate this approach. The authors conclude wedge resection represents a viable, less invasive surgical option for lung cancer patients with IPF, particularly those with severe hypoxemia or previous lung surgery, balancing cancer control with preservation of lung function and minimizing AE risk.

Asset Subtitle

Madoka Toyoda

Meta Tag

Speaker Madoka Toyoda

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

idiopathic pulmonary fibrosis

IPF

lung cancer

video-assisted thoracoscopic surgery

VATS wedge resection

acute exacerbation

postoperative complications

lung function preservation

survival rate

local recurrence