Surgery today · 2017
What factors determine the survival of patients with an acute exacerbation of interstitial lung disease after lung cancer resection?
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Miyajima Masahiro, Watanabe Atsushi, Sato Toshihiko, Teramukai Satoshi, Ebina Masahito, Kishi Kazuma, Sugiyama Yukihiko, Kondo Haruhiko, Kobayashi Satoru, Takahashi Yutaka, Ito Hiroyuki, Yamamoto Ryoji, Sawada Shigeki, Fujimori Hideki, Okabe Kazunori, Arikura Jun, Shintani Yasushi, Nakamura Hiroshige, Toyooka Shinichi, Hasumi Tohru, Watanabe Takehiro, Hata Yoshinobu, Iwata Hisashi, Aoki Minoru, Funai Kazuhito, Inoue Shuhei, Kawashima Osamu, Iida Tomohiko, Date Hiroshi
Аннотация
PURPOSES: Acute exacerbation of interstitial pneumonia (AEIP) is a leading cause of death after lung cancer resection in patients with interstitial lung disease.
METHODS: We retrospectively analyzed 1763 patients with non-small cell lung cancer with a clinical diagnosis of interstitial lung disease (ILD) who underwent lung cancer resection between 2000 and 2009 at 61 hospitals in Japan. AEIP occurred in 164 of 1763 (9.3%) patients with a mortality rate of 43.9% (72/164). Univariate and multivariate analyses were carried out to identify possible risk factors of fatal AEIP. We then analyzed the 164 patients who developed postoperative AEIP and identified the preoperative and postoperative risk factors.
RESULTS: A multivariate regression analysis identified that the sex, percent vital capacity, neoadjuvant radiation, preoperative history of AEIP, preoperative use of steroids, usual interstitial pneumonia pattern on CT, and surgical procedures were independent preoperative risk factors for death due to AEIP. ILD patients with emphysema somehow showed a lower risk of fatal AEIP than those without emphysema in this study.
CONCLUSIONS: This study revealed eight risk factors for fatal AEIP.
METHODS: We retrospectively analyzed 1763 patients with non-small cell lung cancer with a clinical diagnosis of interstitial lung disease (ILD) who underwent lung cancer resection between 2000 and 2009 at 61 hospitals in Japan. AEIP occurred in 164 of 1763 (9.3%) patients with a mortality rate of 43.9% (72/164). Univariate and multivariate analyses were carried out to identify possible risk factors of fatal AEIP. We then analyzed the 164 patients who developed postoperative AEIP and identified the preoperative and postoperative risk factors.
RESULTS: A multivariate regression analysis identified that the sex, percent vital capacity, neoadjuvant radiation, preoperative history of AEIP, preoperative use of steroids, usual interstitial pneumonia pattern on CT, and surgical procedures were independent preoperative risk factors for death due to AEIP. ILD patients with emphysema somehow showed a lower risk of fatal AEIP than those without emphysema in this study.
CONCLUSIONS: This study revealed eight risk factors for fatal AEIP.
Предметные рубрики MeSH
Acute DiseaseAdultAgedAged, 80 and overAnalysis of VarianceCarcinoma, Non-Small-Cell LungCause of DeathDisease ProgressionFemaleHumansLung Diseases, InterstitialLung NeoplasmsMaleMiddle AgedNeoadjuvant TherapyPneumonectomyPulmonary EmphysemaRetrospective StudiesRisk FactorsSex FactorsTomography, X-Ray ComputedVital Capacity