Preoperative use of inhaled tiotropium in lung cancer patients with untreated COPD

Seiichi Kobayashi, Satoshi Suzuki, Hiromichi Niikawa, Takafumi Sugawara, Masaru Yanai

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)

Abstract

Background and objective: Lung cancer patients with COPD are at high risk during surgery. Tiotropium, a long-acting bronchodilator, is a preferred maintenance therapy for COPD, but its efficacy in the perioperative period has not been clarified. Methods: A retrospective review was performed of the medical records of 102 patients with primary lung cancer and COPD, who underwent scheduled surgery. Twenty-one lung cancer patients with untreated mild-to-severe COPD received tiotropium preoperatively. Spirometry was performed prior to and after 2 weeks of treatment with tiotropium, and at 3 months after surgery. Results: Two-week preoperative treatment with tiotropium significantly improved respiratory symptoms and pulmonary function as reflected by FVC (median 3.43 L pretreatment vs 3.52 L post-treatment), FEV1 (median 2.06 L vs 2.32 L) and FEV1% (73.2% vs 81.0%) (all P < 0.001). Postoperative FEV1% was significantly increased from a median of 56.0% (interquartile range 51.6-60.3) to 63.4% (60.8-66.0) (P < 0.001). The increase in FEV1 was inversely associated with severity of COPD (r = -0.59, P < 0.005). Lung resections were successfully accomplished without complications. The postoperative FEV1 predicted prior to tiotropium treatment was underestimated (median predicted postoperative FEV1 1.65 L vs median measured postoperative FEV1 1.96 L, P < 0.001). Conclusions: Preoperative treatment with tiotropium may facilitate surgical treatment for lung cancer patients with COPD. This is encouraging for COPD patients who may require curative lung resections.

Original languageEnglish
Pages (from-to)675-679
Number of pages5
JournalRespirology
Volume14
Issue number5
DOIs
Publication statusPublished - 2009 Jul 1
Externally publishedYes

Keywords

  • Chronic obstructive pulmonary disease
  • Lung cancer
  • Thoracic surgery
  • Tiotropium

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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