What factors determine the survival of patients with an acute exacerbation of interstitial lung disease after lung cancer resection?

• Published in: Surgery today (Tokyo, Japan) Japan), 2018-04, Vol.48 (4), p.404-415
• Main Authors: 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
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Aged; Aged, 80 and over; Analysis of Variance; Carcinoma, Non-Small-Cell Lung - complications; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - surgery; Cause of Death; Disease Progression; Female; Humans; Lung Diseases, Interstitial - etiology; Lung Diseases, Interstitial - mortality; Lung Neoplasms - complications; Lung Neoplasms - mortality; Lung Neoplasms - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Neoadjuvant Therapy; Original Article; Pneumonectomy; Pulmonary Emphysema; Retrospective Studies; Risk Factors; Sex Factors; Surgery; Surgical Oncology; Tomography, X-Ray Computed; Vital Capacity
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-017-1605-8

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.