Pulm Med. 2026;2026(1):e4702786. doi: 10.1155/pm/4702786.
ABSTRACT
OBJECTIVE: The purpose of this study was to investigate the value of therapeutic bronchoscopy in malignant central airway obstruction (MCAO) patients secondary to non-small cell lung cancer (NSCLC), especially in those experiencing respiratory failure (RF).
METHODS: This retrospective cohort study was conducted on 101 cases of NSCLC-related MCAO patients who received therapeutic bronchoscopy from January 2018 to January 2025. Patients were classified into the RF group (n = 39) and the non-RF group (n = 62) based on the presence of RF (PaO2/FiO2 ≤ 300) resulting from MCAO.
RESULTS: Therapeutic bronchoscopy achieved technical success in 93.1% of 101 patients, with no significant differences in technical success (p = 0.521), complication rates (p = 0.147), and short-term or intermediate-term efficacy between RF and non-RF groups. Kaplan-Meier curves indicated a median survival of 16.98 months posttherapeutic bronchoscopy, with univariate analysis revealing statistically significant differences between the RF and non-RF groups (10.46 months vs. 18.62 months, log – rank χ2 = 4.494, p = 0.034). Multivariate Cox survival regression indicated that ECOG PS of 3-4 points (HR = 3.437, 95% CI: 1.751-6.746, p < 0.001), serum lactate dehydrogenase (LDH) ≥ 250 U/L (HR = 2.538, 95% CI: 1.328-4.852, p = 0.005), and lack of systemic antitumor treatment (HR = 3.274, 95% CI: 1.481-7.235, p = 0.003) are risk factors affecting the 2-year survival of NSCLC-related MCAO patients. Notably, the presence of secondary RF, the location, and the degree of airway stenosis in patients before surgery were not associated with the prognosis (p > 0.05).
CONCLUSION: Therapeutic bronchoscopy is safe and effective in NSCLC patients with MCAO. This intervention should be performed promptly when airway narrowing causes RF. The ECOG PS, serum LDH level, and systemic antitumor treatment might be independent factors affecting the prognosis of MCAO patients.
PMID:42473740 | DOI:10.1155/pm/4702786
