Impact of GAP score on surgical prognosis of non-small-cell lung cancer with usual interstitial pneumonia.

IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Mariko Fukui, Takeshi Matsunaga, Aritoshi Hattori, Kazuya Takamochi, Hisashi Tomita, Shuko Nojiri, Kenji Suzuki
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引用次数: 0

Abstract

Objective: Post-surgical survival outcomes in patients with non-small-cell lung cancer (NSCLC) and idiopathic pulmonary fibrosis (IPF) are expected to be worse than those in patients with other idiopathic interstitial pneumonias (IIPs). However, these remain unclear regarding patients with NSCLC and IPF histologically diagnosed as usual interstitial pneumonia [IPF(UIP)]. We aimed to assess the surgical and survival outcomes and identify prognostic factors in patients with NSCLC and IPF(UIP).

Methods: This retrospective cohort study included patients with pathological stage I-III NSCLC and UIP. Prognostic factors and their association with lung cancer deaths (LCDs) and non-LCDs (NLCDs) were investigated.

Results: The overall survival of patients with UIP was significantly poorer than that of others with IIPs. The main causes of death were lung cancer (36%) and respiratory disease (44%). Multivariate analyses revealed the pathological stage of NSCLC ≥ II (hazard ratio [HR], 2.196; p = 0.009) and GAP stage ≥ II (HR, 2.821; p = 0.016) to be significant prognostic factors. NLCD incidence was significantly high in patients with GAP stage ≥ II. Recurrence occurred in 26 patients (36.1%); the period from recurrence to death was shorter in patients with IPF(UIP) than in patients without IPF(UIP).

Conclusions: Patients with NSCLC and IPF(UIP) had poor prognosis after surgery. However, the prognosis varied greatly depending on the GAP stage. Considering the difficulty in managing post-surgical recurrence and high incidence of LCDs in patients with IPF(UIP), pursuing a radical resection is recommended in patients with GAP stage I. For patients with GAP stage ≥ II, comprehensive management of UIP is also necessary.

GAP 评分对非小细胞肺癌合并常见间质性肺炎手术预后的影响
目的:非小细胞肺癌(NSCLC)和特发性肺纤维化(IPF)患者手术后的生存效果预计会比其他特发性间质性肺炎(IIPs)患者差。然而,对于组织学诊断为普通间质性肺炎[IPF(UIP)]的 NSCLC 和 IPF 患者,这些情况仍不清楚。我们旨在评估 NSCLC 和 IPF(UIP)患者的手术和生存结果,并确定预后因素:这项回顾性队列研究纳入了病理分期为 I-III 期的 NSCLC 和 UIP 患者。研究调查了预后因素及其与肺癌死亡(LCD)和非肺癌死亡(NLCD)的关系:结果:UIP 患者的总生存率明显低于其他 IIP 患者。主要死因是肺癌(36%)和呼吸系统疾病(44%)。多变量分析显示,NSCLC病理分期≥II(危险比[HR],2.196;P = 0.009)和GAP分期≥II(HR,2.821;P = 0.016)是重要的预后因素。GAP分期≥II的患者NLCD发生率明显较高。26例患者(36.1%)出现复发;与非IPF(UIP)患者相比,IPF(UIP)患者从复发到死亡的时间更短:结论:NSCLC和IPF(UIP)患者术后预后较差。结论:NSCLC 和 IPF(UIP)患者术后预后较差,但根据 GAP 分期的不同,预后也有很大差异。考虑到处理 IPF(UIP)患者术后复发的难度和 LCD 的高发生率,建议对 GAP 分期为 I 期的患者进行根治性切除。
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来源期刊
General Thoracic and Cardiovascular Surgery
General Thoracic and Cardiovascular Surgery Medicine-Pulmonary and Respiratory Medicine
CiteScore
2.70
自引率
8.30%
发文量
142
期刊介绍: The General Thoracic and Cardiovascular Surgery is the official publication of The Japanese Association for Thoracic Surgery and The Japanese Association for Chest Surgery, the affiliated journal of The Japanese Society for Cardiovascular Surgery, that publishes clinical and experimental studies in fields related to thoracic and cardiovascular surgery.
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