Controlling nutritional status predicts postoperative survival and acute exacerbation in resected non-small cell lung cancer with interstitial lung disease

IF 4.5 2区医学 Q1 ONCOLOGY

Lung Cancer Pub Date : 2025-05-21 DOI:10.1016/j.lungcan.2025.108591

Taichi Matsubara , Mototsugu Shimokawa , Sho Wakasu , Akira Haro , Masafumi Yamaguchi , Motoharu Hamatake

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Abstract

Background

Several immune-nutritional markers have been reported as convenient prognostic factors in malignancies, including lung cancer. The controlling nutritional status (CONUT) score has been reported as a prognostic factor in patients with resected lung cancer. However, its significance in resected cases of lung cancer complicated by interstitial lung disease (ILD) has not been previously reported.

Methods

This study included 120 patients with non-small cell lung cancer complicated by ILD who underwent lung resection at our department between 2010 and 2019. Based on the CONUT score, patients were classified into three groups: normal (0–1 points), mildly undernourished (2–4 points), and moderately undernourished (5–8 points).

Results

The median age of patients was 73 years, and 86.7 % were male. ILD imaging patterns were categorized as usual interstitial pneumonia (UIP), probable UIP, or indeterminate UIP in 21.7 %, 62.5 %, and 15.8 % of cases, respectively. Postoperative acute exacerbation (AE) occurred in 16 patients (13.7 %), with eight deaths attributable to AE. Among the nutritional groups, AE-ILD incidence was 9 %, 16 %, and 33 % in the normal, mildly undernourished, and moderately undernourished groups. Logistic regression analysis identified the CONUT score as an independent risk factor for AE, alongside other factors such as sex, surgical technique, imaging findings, history of ILD exacerbation, steroid use, Krebs von den Lungen-6 levels, and predicted vital capacity.

Conclusions

The CONUT score emerged as a significant prognostic factor and an independent risk factor for AE in patients with resected lung cancer complicated by ILD.

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控制营养状况可预测切除非小细胞肺癌合并间质性肺疾病的术后生存和急性加重

一些免疫营养标志物已被报道为恶性肿瘤（包括肺癌）的便捷预后因素。控制营养状况（CONUT）评分已被报道为肺癌切除术患者的预后因素。然而，其在肺癌合并间质性肺疾病（ILD）的切除病例中的意义尚未见报道。方法本研究纳入2010年至2019年在我科行肺切除术的120例非小细胞肺癌合并ILD患者。根据CONUT评分，将患者分为正常（0-1分）、轻度营养不良（2-4分）和中度营养不良（5-8分）三组。结果患者中位年龄73岁，男性占86.7%。在21.7%、62.5%和15.8%的病例中，ILD影像学模式分别被归类为通常间质性肺炎（UIP）、可能间质性肺炎和不确定间质性肺炎。16例（13.7%）患者发生术后急性发作（AE），其中8例死亡归因于AE。在营养组中，AE-ILD在正常、轻度营养不良和中度营养不良组的发病率分别为9%、16%和33%。Logistic回归分析确定CONUT评分是AE的独立危险因素，其他因素包括性别、手术技术、影像学表现、ILD恶化史、类固醇使用、克雷勃氏肺-6水平和预测肺活量。结论CONUT评分是切除肺癌合并ILD患者AE的重要预后因素和独立危险因素。

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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来源期刊

Lung Cancer 医学-呼吸系统

CiteScore

9.40

自引率

3.80%

发文量

407

审稿时长

25 days

期刊介绍： Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.