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Clinical Outcomes and Prognosis of Patients with Interstitial Lung Disease Undergoing Lung Cancer Surgery: A Propensity Score Matching Study

 Min Seo Ki  ;  Song Yee Kim  ;  Eun Young Kim  ;  Ji Ye Jung  ;  Young Ae Kang  ;  Moo Suk Park  ;  Young Sam Kim  ;  Seong Yong Park  ;  Sang Hoon Lee 
 CLINICAL LUNG CANCER, Vol.24(1) : e27-e38, 2023-01 
Journal Title
Issue Date
Humans ; Idiopathic Pulmonary Fibrosis* / surgery ; Lung Diseases, Interstitial* ; Lung Neoplasms* ; Male ; Prognosis ; Propensity Score ; Retrospective Studies
ILD-GAP index ; IPF ; Non-IPF ; Pulmonary resection ; Survival
Background: Patients with interstitial lung disease (ILD) may have a poor prognosis after lung cancer surgery because of respiratory complications and increased recurrence rates due to limited resection. Few studies have investigated prognosis after surgery by matching clinical variables between patients with and without ILD.

Patients and methods: Medical records of patients who underwent lung cancer surgery between January 2010 and August 2020 at a referral hospital in South Korea were reviewed. Patients with ILD were identified based on preoperative computed tomography findings. Through propensity score matching, the clinical outcomes and prognoses of patients with (ILD group) and without ILD (control group) were compared.

Results: Of 1629 patients, 113 (6.9%) patients with ILD were identified, of whom 104 patients were matched. Before matching, patients with ILD had higher mean age, proportion of men, and rates of sublobar resection and squamous cell carcinoma than those without ILD. After matching, there was no significant difference in postoperative mortality rates between the control and ILD groups. The 5-year survival rate was significantly lower in the ILD group (66%) than in the control group (78.8%; P= .007). The 5-year survival rate of the ILD-GAP (Gender, Age, Physiology) stage III group (12.6%) was significantly lower than that of the ILD-GAP stage I (73.5%) and II groups (72.6%; P< .0001). Multivariable Cox analysis demonstrated that idiopathic pulmonary fibrosis, higher clinical stage, and recurrence were independent prognostic factors for mortality.

Conclusion: Concomitant ILD negatively affects long-term prognosis after lung cancer surgery, and ILD subtype and physiological severity assessment help predict prognosis after surgery.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Young Ae(강영애) ORCID logo https://orcid.org/0000-0002-7783-5271
Ki, Min Seo(기민서)
Kim, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Kim, Eun Young(김은영) ORCID logo https://orcid.org/0000-0002-3281-5744
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Park, Seong Yong(박성용) ORCID logo https://orcid.org/0000-0002-5180-3853
Lee, Sang Hoon(이상훈) ORCID logo https://orcid.org/0000-0002-7706-5318
Jung, Ji Ye(정지예) ORCID logo https://orcid.org/0000-0003-1589-4142
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