BACKGROUND Malignant central airway obstruction (MCAO) occurs in 20-30% of patients with primary pulmonary malignancy. Although bronchoscopic intervention is widely performed to treat MCAO, little data exist on the prognosis of interventional bronchoscopy. Therefore, we evaluated the clinical outcomes and prognostic factors of bronchoscopic interventions in patients with MCAO due to primary pulmonary malignancy. METHODS This retrospective study was conducted at a university hospital and included 224 patients who received interventional bronchoscopy from 2004 to 2017, excluding patients with salivary gland-type tumor. A multivariable Cox proportional hazard regression analysis was used to identify independent prognostic factors associated with survival after the first bronchoscopic intervention. RESULTS Among 224 patients, 191 (85.3%) were males, and the median age was 63 years. The most common histological type of malignancy was squamous cell carcinoma (71.0%). Technical success was achieved in 93.7% of patients. Acute complications and procedure-related death occurred in 15.6 and 1.3% of patients, respectively. The median survival time was 7.0 months, and survival rates at one year and two years were 39.7 and 28.3%, respectively. Poor survival was associated with underlying chronic pulmonary disease, poor performance status, extended lesion, extrinsic or mixed lesion, and MCAO due to disease progression and not receiving adjuvant treatment after bronchoscopic intervention. CONCLUSIONS Interventional bronchoscopy could be a safe and effective procedure for patients who have MCAO due to primary pulmonary malignancy. In addition, we found several prognostic factors for poor survival after intervention, which will help clinicians determine the best candidates for bronchoscopic intervention.

中文翻译：

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因原发性肺部恶性肿瘤而在气道阻塞患者中进行支气管镜干预后生存的预后因素。

背景恶性中央气道阻塞（MCAO）发生在20-30％的原发性肺恶性肿瘤患者中。尽管支气管镜干预被广泛用于治疗MCAO，但关于介入性支气管镜预后的数据很少。因此，我们评估了由于原发性肺部恶性肿瘤而在MCAO患者中进行支气管镜干预的临床结果和预后因素。方法这项回顾性研究在一家大学医院进行，纳入了2004年至2017年接受224例行支气管镜检查的患者，不包括唾液腺型肿瘤患者。使用多变量Cox比例风险回归分析来确定与首次支气管镜干预后生存相关的独立预后因素。结果224例患者中，男性191例（85.3％），平均年龄为63岁。恶性肿瘤最常见的组织学类型是鳞状细胞癌（71.0％）。93.7％的患者获得了技术成功。急性并发症和与手术相关的死亡分别发生在15.6和1.3％的患者中。中位生存时间为7.0个月，一年和两年生存率分别为39.7和28.3％。生存不良与潜在的慢性肺部疾病，机能状态差，病灶扩展，外在或混合病灶以及由于疾病进展且在支气管镜干预后未接受辅助治疗的MCAO有关。结论对于因原发性肺恶性肿瘤而患有MCAO的患者，介入支气管镜检查可能是一种安全有效的方法。此外，