LAUSR

Purpose To assess the efficacy and feasibility of perioperative pirfenidone treatment (PPT) in lung cancer patients with idiopathic pulmonary fibrosis (IPF). Methods The subjects of this retrospective review were 100 patients diagnosed with IPF, who underwent surgical resection for primary lung cancer between January 2011 and April 2018 at our institution. We compared the clinical outcomes of patients treated with pirfenidone (PPT group; n  = 28) and those of patients not treated with pirfenidone (non-PPT group; n  = 72). Results The Japanese Association for Chest Surgery (JACS) risk score was significantly higher in the PPT group ( p  = 0.020, 10.9 vs. 9.4); therefore, we subdivided the groups based on JACS risk score. In the low-risk group, the incidence of postoperative acute exacerbation (AE) both within the postoperative day (POD) 30 and 90 was 0.0% (0/6) and 6.5% (2/31) in the PPT and non-PPT groups, respectively ( p  = 0.522). In the intermediate/high-risk group, the incidence of postoperative AE was 4.5% (1/22) and 19.5% (8/41) within POD 30 ( p  = 0.106) and 4.5% (1/22) and 24.4% (10/41) within POD 90 ( p  = 0.048) in the PPT and non-PPT groups, respectively. No serious pirfenidone-related complications were observed. Conclusions Based on our findings, PPT is an effective and feasible prophylactic treatment to reduce postoperative AE.