General thoracic and cardiovascular surgery · 2025
Surgical outcomes and prognoses of patients with clinical stage I lung cancer and interstitial lung disease.
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Kayawake Hidenao, Soda Momoko, Takayama Masakazu, Yokoyama Yuhei, Yamada Tetsu, Tachikawa Ryo, Tomii Keisuke, Hamakawa Hiroshi, Takahashi Yutaka
Аннотация
OBJECTIVE: Studies have reported poor surgical outcomes in patients with lung cancer and interstitial lung disease. Therefore, we retrospectively analyzed the perioperative and long-term outcomes of this patient population.
METHODS: Between 2004 and 2021, we enrolled 103 patients with interstitial lung disease and clinical stage I lung cancer (8th edition of the TNM classification) without a history of lung cancer treatment within 5 years before surgery and undergoing complete resection from our institution.
RESULTS: The median patient age was 74 years (range: 60-89 years), and 90 patients were male. The most common surgical procedures were lobectomy (n = 85), followed by partial resection (n = 13), segmentectomy (n = 4), and pneumonectomy (n = 1). The median observation period was 1102 days. Concerning perioperative outcomes, 90-day postoperative mortality was 7 (6.8%) and complications (≥ Grade 3 according to the Clavien-Dindo classification) were observed in 30 patients (29.1%). Regarding long-term outcomes, lung cancer recurrence was observed in 38 patients. Fifty-six patients died during the observation period, but only 20 (35.7%) died of lung cancer recurrence. Pathological upstaging was observed in 51 patients (49.5%). The 5-year overall survival and recurrence-free survival rates were 48.6% and 41.8%, respectively.
CONCLUSIONS: A relatively high 90-day mortality rate was observed. Deaths from causes other than lung cancer recurrence were observed more frequently than those from lung cancer recurrence. Hence, when selecting treatment strategies for early lung cancer combined with interstitial lung disease, the risks of acute exacerbation and progression of interstitial lung disease should be considered.
METHODS: Between 2004 and 2021, we enrolled 103 patients with interstitial lung disease and clinical stage I lung cancer (8th edition of the TNM classification) without a history of lung cancer treatment within 5 years before surgery and undergoing complete resection from our institution.
RESULTS: The median patient age was 74 years (range: 60-89 years), and 90 patients were male. The most common surgical procedures were lobectomy (n = 85), followed by partial resection (n = 13), segmentectomy (n = 4), and pneumonectomy (n = 1). The median observation period was 1102 days. Concerning perioperative outcomes, 90-day postoperative mortality was 7 (6.8%) and complications (≥ Grade 3 according to the Clavien-Dindo classification) were observed in 30 patients (29.1%). Regarding long-term outcomes, lung cancer recurrence was observed in 38 patients. Fifty-six patients died during the observation period, but only 20 (35.7%) died of lung cancer recurrence. Pathological upstaging was observed in 51 patients (49.5%). The 5-year overall survival and recurrence-free survival rates were 48.6% and 41.8%, respectively.
CONCLUSIONS: A relatively high 90-day mortality rate was observed. Deaths from causes other than lung cancer recurrence were observed more frequently than those from lung cancer recurrence. Hence, when selecting treatment strategies for early lung cancer combined with interstitial lung disease, the risks of acute exacerbation and progression of interstitial lung disease should be considered.