Long-term survival after complete resection of non-small-cell lung cancer in patients with interstitial lung disease

Interact Cardiovasc Thorac Surg. 2018 Apr 1;26(4):638-643. doi: 10.1093/icvts/ivx400.

Abstract

Objectives: Patients with lung cancer and interstitial lung disease (ILD), usual interstitial pneumonia in particular, are known to have a poor outcome. The aim of this study was to evaluate the prognostic impact of ILD in patients with non-small-cell lung cancer.

Methods: A total of 2054 consecutive patients underwent complete resection of Stage IA-IIIA non-small-cell lung cancer in our institution between January 2002 and March 2013. The presence of ILD was diagnosed and categorized based on high-resolution computed tomography images. Multivariate analysis was performed to identify the prognostic factors.

Results: There were 106 (5%) patients with ILD. There were significantly more patients who developed severe complications (P < 0.01) in the ILD group, with 4 (4%) patients developing acute exacerbation. Although the difference in postoperative mortality rate was marginal between the groups (P = 0.07), the 5-year overall survival and cancer-specific survival rates of the ILD patients were significantly worse than those of the non-ILD group (overall survival: 40.4% vs 72.0%, P < 0.01; cancer-specific survival 55.4% vs 78.6%, P < 0.01). The results of multivariate analysis showed that coexistence of ILD (hazard ratio 1.45; P = 0.01) was an independent, unfavourable prognostic factor.

Conclusions: The presence of ILD led to a much poorer survival after complete resection of non-small-cell lung cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / complications
  • Carcinoma, Non-Small-Cell Lung / mortality*
  • Carcinoma, Non-Small-Cell Lung / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Japan / epidemiology
  • Lung Diseases, Interstitial / complications*
  • Lung Diseases, Interstitial / mortality
  • Lung Diseases, Interstitial / surgery
  • Lung Neoplasms / complications
  • Lung Neoplasms / mortality*
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Pneumonectomy*
  • Prognosis
  • Survival Rate / trends
  • Time Factors
  • Young Adult