Sarcopenia as determined using preoperative computed tomography could be used to predict postoperative major complication and prognosis in patients with resected NSCLC. Our results may provide some important information for preoperative management.
Interstitial lung disease (ILD) and lung cancer are two of the most common respiratory diseases. The aim of this study was to demonstrate the prognostic significance of the presence of ILD in patients with small cell lung cancer (SCLC). All the patients with SCLC who were admitted to our hospitals over a 23-year period up to 2008 were retrospectively analyzed. During the study period, 332 SCLC patients were consecutively admitted to our hospitals. Among them, 15 (4.5%) were diagnosed as having both SCLC and ILD. In univariate and multivariate analysis, female sex, early stage, good performance status, and chemotherapy were favorable prognostic factors. The presence of ILD was confirmed as an unfavorable prognostic factor. Existing ILD adversely affects the outcome of SCLC. When deciding whether to offer a standard therapy that may increase treatment-related mortality, the patient's medical condition, including ILD, should be taken into consideration.
Combination therapy with immune checkpoint inhibitors and cytotoxic chemotherapies (chemoimmunotherapy) is associated with significantly better survival outcomes than cytotoxic chemotherapies alone in patients with advanced non-small cell lung cancer (NSCLC). However, there are no prognostic markers for chemoimmunotherapy. The prognostic nutritional index (PNI) and lung immune prognostic index (LIPI) are prognostic biomarkers for immune checkpoint inhibitor (ICI) monotherapy or cytotoxic chemotherapies. Thus, we aimed to examine whether these factors could also be prognostic markers for chemoimmunotherapy. We retrospectively examined 237 patients with advanced NSCLC treated with chemoimmunotherapy. In the total group, the median overall survival (OS) was not reached, and the median progression-free survival (PFS) was 8.6 months. Multivariate analysis of OS and PFS revealed significant differences based on PNI and LIPI. Programmed cell death ligand 1 (PD-L1) was also significantly associated with OS and PFS. PNI and a PD-L1 tumor proportion score (TPS) of <50% and poor LIPI (regardless of PD-L1 TPS) were associated with poor prognosis. PNI and LIPI predicted survival outcomes in patients with advanced NSCLC treated with chemoimmunotherapy, especially in patients with PD-L1 TPS <50%. For patients in this poor category, chemoimmunotherapy may result in a worse prognosis than expected.
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