The effectiveness of surgical treatment of patients with lung cancer in combination with active tuberculosis

The aim of the study. To evaluate the results of surgical treatment of lung cancer with active tuberculosis performed in a tuberculosis institution.

Materials and methods. We analyzed the immediate and long-term results of surgical interventions for lung cancer in patients with concomitant active tuberculosis (15 people, 0.7% of all patients discharged from the tuberculosis surgical department in 2016-2020), 12 men and 3 women aged 49- 64 years old.The log-rank test was used to analyze possible factors influencing patient survival.

Results. Surgical interventions were more often performed in cases of combination of active tuberculosis and stage IA lung cancer (60%). Anatomical resections including lobectomies, combined resections and pneumonectomies were performed in 66.6% of cases.The incidence of postoperative complications was 6.6%; mortality during 5 years of observation was 46.7% (95% CI 24.8-69.9%) of cases. The overall 5-year survival rate (53.3%, 95% CI 30.1-75.2%) after surgical treatment did not depend on the activity of  TB process. Unfavorable factors influencing the risk of death were stage III lung cancer, squamous cell carcinoma, ipsilateral localization of cancer and tuberculous process (in the same lung).

Conclusion. Surgical treatment of lung cancer in patients with active tuberculosis in a tuberculosis institution is characterized by an overall 5-year survival rate of 53.3%, a low level of postoperative complications, and the absence of hospital mortality and tuberculosis reactivation.

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