Automated Measurement of Coronary Artery Calcifications and Routine Perioperative Blood Tests Predict Survival in Resected Stage I Lung Cancer

IF 3 Q2 ONCOLOGY

JTO Clinical and Research Reports Pub Date : 2025-01-08 DOI:10.1016/j.jtocrr.2025.100788

Federica Sabia MSc , Camilla Valsecchi MSc , Roberta Eufrasia Ledda MD , Giorgio Bogani MD , Riccardo Orlandi MD , Luigi Rolli MD , Michele Ferrari MD , Maurizio Balbi MD , Alfonso Marchianò MD , Ugo Pastorino MD

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引用次数: 0

Abstract

Introduction

Coronary artery calcification (CAC) is a well-known cardiovascular risk factor. In the past year, the CAC score has been investigated in lung cancer (LC) screening, suggesting promising results in terms of mortality risk assessment. Nevertheless, its role in patients with LC is still to be investigated. This study aimed to evaluate the performance of a fully automated CAC scoring alone and combined with a prognostic index on the basis of perioperative routine blood tests in predicting 5-year survival of patients with stage I LC.

Methods

This study included 536 consecutive patients with stage I LC who underwent preoperative chest computed tomography followed by surgical resection. The CAC score was measured by commercially available, fully automated artificial intelligence software. The primary outcome was the 5-year overall survival rate.

Results

A total of 110 patients (20.5%) had a CAC score greater than or equal to 400, 149 (27.8%) between 100 and 399, and 277 (51.7%) had less than 100. Male smokers had the highest CAC values: 32% compared with only 17% of nonsmokers. Females had lower CAC values compared with males both in smokers and nonsmokers: CAC greater than or equal to 400 only for 10% of smoking females and 0% in nonsmoking females. The 5-year survival was 80.3% overall, 84.7% in CAC less than 100, 77.5% in CAC 100 to 399, and 73.5% in CAC greater than or equal to 400 (p = 0.0047).

Conclusions

We observed that the CAC score predicted the 5-year overall survival in patients with resected stage I LC, both alone and combined with the modified routine blood test score. These results open new prospects for the prevention of noncancer mortality in patients with early-stage LC.

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冠状动脉钙化的自动测量和常规围手术期血液检查预测切除的I期肺癌患者的生存

冠状动脉钙化（CAC）是众所周知的心血管危险因素。在过去的一年中，人们对肺癌（LC）筛查中的CAC评分进行了研究，在死亡风险评估方面显示出令人鼓舞的结果。然而，其在LC患者中的作用仍有待研究。本研究旨在评估全自动CAC评分和基于围手术期常规血液检查的预后指标在预测I期LC患者5年生存中的作用。方法本研究纳入536例连续一期LC患者，术前行胸部计算机断层扫描，术后行手术切除。CAC分数是由市售的全自动人工智能软件测量的。主要终点是5年总生存率。结果CAC评分≥400的有110例（20.5%），100 ~ 399的有149例（27.8%），小于100的有277例（51.7%）。男性吸烟者的CAC值最高：32%，而非吸烟者只有17%。与男性相比，吸烟和不吸烟女性的CAC值都较低：只有10%的吸烟女性的CAC大于或等于400，而不吸烟女性的CAC值为0%。总体5年生存率为80.3%，CAC小于100的为84.7%，CAC 100 ~ 399的为77.5%，CAC≥400的为73.5% （p = 0.0047）。结论：我们观察到CAC评分可以预测切除的I期LC患者的5年总生存期，无论是单独还是联合改良的常规血液检查评分。这些结果为预防早期LC患者的非癌性死亡率开辟了新的前景。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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