Prognostic impacts of interstitial lung abnormalities on outcomes following resection for lung cancer.

IF 3.4 3区医学 Q1 RESPIRATORY SYSTEM

BMJ Open Respiratory Research Pub Date : 2025-08-28 DOI:10.1136/bmjresp-2024-002981

Charles-Antoine Guay, Pierre-Emile Charest, Frederic-Thomas Caron, Louis Laflamme, Laurie Perreault, Anne-Sophie Laliberté, Elisabeth Albert, Genevieve Dion, Steeve Provencher

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Abstract

Introduction: The clinical significance of interstitial lung abnormalities in patients with lung cancer undergoing curative resection remains largely unstudied. This study aimed to evaluate the prevalence of these findings among patients with lung cancer undergoing resection and assess their impact on postoperative complications and long-term survival.

Methods: This single-centre retrospective study included patients who underwent resection from 2008 to 2020. Patients with a history of lung cancer, previous lung resection or clinically evident interstitial lung disease before cancer detection were excluded. Preoperative chest scans were reviewed for interstitial lung abnormalities according to established criteria. Associations between these abnormalities and postoperative outcomes, as well as long-term survival, were analysed using multivariate models.

Results: Among 1802 patients with available preoperative scans, 114 (6.3%) had interstitial lung abnormalities, including 17 (0.9%) with a usual interstitial pneumonia-like pattern. Interstitial lung abnormalities were associated with older age, female sex and smoking history. Although their presence did not significantly increase the risk of postoperative complications or 30-day mortality, interstitial lung abnormalities were linked to higher long-term mortality (92 vs 61 deaths/1000 person-years, HR 1.47; 95% CI 1.05 to 2.05). The usual interstitial pneumonia-like patterns were significantly associated with increased long-term mortality (HR 2.84; 95% CI 1.36 to 5.91), whereas other patterns were not (HR 0.98; 95% CI 0.63 to 1.54).

Conclusions: Interstitial lung abnormalities are common in patients with lung cancer undergoing curative surgery and are linked to demographic and smoking-related factors. While they do not significantly impact short-term surgical outcomes, usual interstitial pneumonia-like pattern is associated with worse long-term survival.

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肺间质异常对肺癌切除术后预后的影响。

导读：肺癌根治性切除患者间质性肺异常的临床意义尚未得到充分研究。本研究旨在评估这些发现在肺癌切除术患者中的患病率，并评估其对术后并发症和长期生存的影响。方法：这项单中心回顾性研究纳入了2008年至2020年接受手术切除的患者。排除有肺癌病史、既往肺切除或癌前有临床明显间质性肺疾病的患者。术前胸部扫描检查间质性肺异常根据既定标准。使用多变量模型分析这些异常与术后结果以及长期生存之间的关系。结果：在术前扫描的1802例患者中，114例（6.3%）出现间质性肺异常，其中17例（0.9%）表现为常见的间质性肺炎样。肺间质性异常与年龄、女性和吸烟史有关。虽然肺间质性异常的存在并没有显著增加术后并发症或30天死亡率的风险，但肺间质性异常与较高的长期死亡率相关（92 vs 61死亡/1000人年，HR 1.47; 95% CI 1.05 ~ 2.05）。通常的间质性肺炎样模式与长期死亡率增加显著相关（HR 2.84; 95% CI 1.36 ~ 5.91），而其他模式则无显著相关性（HR 0.98; 95% CI 0.63 ~ 1.54）。结论：间质性肺异常在接受根治性手术的肺癌患者中很常见，且与人口统计学和吸烟相关因素有关。虽然它们对短期手术结果没有显著影响，但通常的间质性肺炎样模式与较差的长期生存率相关。

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

BMJ Open Respiratory Research RESPIRATORY SYSTEM-

CiteScore

6.60

自引率

2.40%

发文量

审稿时长

12 weeks

期刊介绍： BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.