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Original research
Impact of interstitial lung abnormalities on postoperative pulmonary complications and survival of lung cancer
  1. Yunjoo Im1,
  2. Man Pyo Chung1,
  3. Kyung Soo Lee2,
  4. Joungho Han3,
  5. Myung Jin Chung4,
  6. Hong Kwan Kim5,
  7. Jong Ho Cho5,
  8. Yong Soo Choi5,
  9. Sujin Park3,
  10. Ho Joong Kim1,
  11. O Jung Kwon1,
  12. Boram Park6,
  13. Hongseok Yoo1
  1. 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  2. 2Department of Radiology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
  3. 3Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  4. 4Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  5. 5Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  6. 6Biomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
  1. Correspondence to Dr. Hongseok Yoo, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea; hongseok.yoo{at}gmail.com; hs.yoo{at}skku.edu

Abstract

Background Interstitial lung abnormalities (ILAs) are associated with the risk of lung cancer and its mortality. However, the impact of ILA on treatment-related complications and survival in patients who underwent curative surgery is still unknown.

Research question This study aimed to evaluate the significance of the presence of computed tomography-diagnosed ILA and histopathologically matched interstitial abnormalities on postoperative pulmonary complications (PPCs) and the long-term survival of patients who underwent surgical treatment for lung cancer.

Study design and methods A matched case–control study was designed to compare PPCs and mortality among 50 patients with ILA, 50 patients with idiopathic pulmonary fibrosis (IPF) and 200 controls. Cases and controls were matched by sex, age, smoking history, tumour location, the extent of surgery, tumour histology and pathological TNM stage.

Results Compared with the control group, the OR of the prevalence of PPCs increased to 9.56 (95% CI 2.85 to 32.1, p<0.001) in the ILA group and 56.50 (95% CI 17.92 to 178.1, p<0.001) in the IPF group. The 5-year overall survival (OS) rates of the control, ILA and IPF groups were 76% (95% CI 71% to 83%), 52% (95% CI 37% to 74%) and 32% (95% CI 19% to 53%), respectively (log-rank p<0.001). Patients with ILA had better 5-year OS than those with IPF (log-rank p=0.046) but had worse 5-year OS than those in the control group (log-rank p=0.002).

Conclusions The presence of radiological and pathological features of ILA in patients with lung cancer undergoing curative surgery was associated with frequent complications and decreased survival.

  • interstitial fibrosis
  • lung cancer
  • thoracic surgery

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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Footnotes

  • YI and MPC contributed equally.

  • Contributors Study conception and design: YI and HY. Data acquisition and analysis: YI, MPC, KSL, JH, MJC, HKK, JHC, YSC, SP, HJK, OJK, BP, HY. Data interpretation and manuscript writing: YI and HY. Critical revision and final approval of the manuscript: all authors. HY is responsable for the overall content as the guarantor.

  • Funding This research was supported by the MSIT (Ministry of Science and ICT), Korea, under the ICT Creative Consilience program (IITP-2021-2020-0-01821) (NTIS 1711126102) supervised by the IITP (Institute for Information and Communications Technology Planning & Evaluation) and SMC-SKKU (Samsung Medical Center-Sungkyunkwan University) grant (SMO1201081).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.