Prognostic impact of surgical-side pulmonary artery diameter in patients with non-small cell lung cancer undergoing lobectomy.

IF 2.3 3区医学 Q3 RESPIRATORY SYSTEM

Journal of thoracic disease Pub Date : 2026-09-30 Epub Date: 2026-08-28 DOI:10.21037/jtd-2026-1627

Shunta Tsuchida, Joji Samejima, Masashi Wakabayashi, Makoto Tada, Tomohiro Miyoshi, Kenta Tane, Keiju Aokage

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引用次数: 0

Abstract

Background: A surgical-side pulmonary artery diameter (ssPAD) ≥23 mm has been linked to postoperative complications after lobectomy for non-small cell lung cancer (NSCLC), but its prognostic significance remains unclear. This study evaluated whether ssPAD ≥23 mm serves as an independent prognostic factor and a useful indicator for preoperative risk assessment.

Methods: We retrospectively analyzed 438 patients who underwent lobectomy for NSCLC between 2016 and 2017. Patients were classified by ssPAD: ≥23 mm (n=116) and <23 mm (n=322). Survival outcomes and clinicopathological variables were compared. The prognostic performance of ssPAD was assessed using C-statistics against main pulmonary artery diameter (MPAD) ≥28 mm and pulmonary artery-to-aorta (PA/A) ratio >1.

Results: The ssPAD ≥23 mm group showed lower 5-year recurrence-free survival (RFS; 61% vs. 71%, P=0.047) and overall survival (OS; 69% vs. 81%, P=0.001). Lung cancer-specific mortality (24% vs. 13%, P=0.03) and non-cancer mortality (15% vs. 7.1%, P=0.042) were higher, while adjuvant therapy was less frequent due to dyspnea. In multivariable analysis, ssPAD ≥23 mm remained an independent predictor of OS [hazard ratio (HR) 1.84, 95% confidence interval (CI): 1.22-2.79, P=0.004].

Conclusions: Preoperative ssPAD ≥23 mm may be an independent prognostic marker after lobectomy for NSCLC and a simple computed tomography (CT)-based tool for risk stratification.

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来源期刊

Journal of thoracic disease RESPIRATORY SYSTEM-

CiteScore

4.60

自引率

4.00%

发文量

254

期刊介绍： The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.