Impact of COPD on Outcomes After Pulmonary Metastasectomy: A Propensity-Score Matched Analysis

作者：Konstantinos Grapatsas, Fabian Doerr, Roemer van Wijk, T. Bergmann, Ilias Arfanis, Viktor Grünwald, Sebastian Bauer, Stephan Lang, Stefan Kasper, Boris Hadaschik, Dirk Schadendorf, Ulf Neumann, Christian Taube, Martin Schüler, Servet Bölükbas, Natalie Baldes · 发表于：Cancers · 年份：2026 · DOI：10.3390/cancers18142353 · 研究领域：Lung Cancer Diagnosis and Treatment、Hepatocellular Carcinoma Treatment and Prognosis、Cancer, Stress, Anesthesia, and Immune Response

Background: Pulmonary metastasectomy (PM) is an established component of multimodal oncological treatment, but its perioperative safety and long-term outcomes in patients with chronic obstructive pulmonary disease (COPD) remain insufficiently defined. We aimed to evaluate the impact of COPD on perioperative morbidity, mortality and long-term survival after PM. Methods: We retrospectively analysed 692 patients who underwent PM with curative intent. COPD severity was graded using the GOLD spirometric classification. Patients were classified according to their postbronchodilator FEV1/FVC ratio into a COPD group (<0.70) and a control group (≥0.70). Groups were compared regarding clinical and surgical characteristics, postoperative morbidity and mortality, and overall survival (Kaplan–Meier, log-rank). Independent predictors of morbidity and survival were identified via logistic and Cox regression, and a 1:1 propensity-score-matched analysis was performed to account for baseline imbalances. Results: Among 9684 patients, 692 (7.1%) patients underwent PM, of whom 171 (24.7%) had COPD. They were more frequently smokers and had a higher comorbidity burden and worse performance status and, as expected, significantly lower lung function. The main clinically relevant finding was a significantly higher rate of persistent air leak in patients with COPD (8.8% vs. 2.3%, p < 0.001). Overall morbidity and 30-day mortality, however, did not differ. With a median follow-up of 76.7 months, ...