Abstract
Background
Patients with interstitial lung disease (ILD) may have a poor prognosis after lung
cancer surgery because of respiratory complications and increased recurrence rates
due to limited resection. Few studies have investigated prognosis after surgery by
matching clinical variables between patients with and without ILD.
Patients and Methods
Medical records of patients who underwent lung cancer surgery between January 2010
and August 2020 at a referral hospital in South Korea were reviewed. Patients with
ILD were identified based on preoperative computed tomography findings. Through propensity
score matching, the clinical outcomes and prognoses of patients with (ILD group) and
without ILD (control group) were compared.
Results
Of 1629 patients, 113 (6.9%) patients with ILD were identified, of whom 104 patients
were matched. Before matching, patients with ILD had higher mean age, proportion of
men, and rates of sublobar resection and squamous cell carcinoma than those without
ILD. After matching, there was no significant difference in postoperative mortality
rates between the control and ILD groups. The 5-year survival rate was significantly
lower in the ILD group (66%) than in the control group (78.8%; P= .007). The 5-year survival rate of the ILD-GAP (Gender, Age, Physiology) stage III
group (12.6%) was significantly lower than that of the ILD-GAP stage I (73.5%) and
II groups (72.6%; P< .0001). Multivariable Cox analysis demonstrated that idiopathic pulmonary fibrosis,
higher clinical stage, and recurrence were independent prognostic factors for mortality.
Conclusion
Concomitant ILD negatively affects long-term prognosis after lung cancer surgery,
and ILD subtype and physiological severity assessment help predict prognosis after
surgery.
Keywords
Abbreviations:
BMI (body mass index), CT (computed tomography), DLCO (carbon monoxide diffusing capacity), ECOG (Eastern Cooperative Oncology Group), FEV1 (forced expiratory volume in 1 s), FVC (forced vital capacity), IIP (idiopathic interstitial pneumonia, ILD-AE, interstitial lung disease acute exacerbation), ILD (interstitial lung disease), IPF (idiopathic pulmonary fibrosis), NSCLC (non-small cell lung cancer), PFT (pulmonary function test), PSM (propensity score matching), UIP (usual interstitial pneumonia)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 13, 2022
Accepted:
October 9,
2022
Received in revised form:
August 22,
2022
Received:
May 12,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
