Prediction of postoperative exacerbation of interstitial pneumonia in patients with lung cancer and interstitial lung disease

Iyoda, Akira; Jiang, Shi‐Xu; Aoki, Hideki; Ogawa, Fumihiro; Matui, Yoshio; Kurouzu, Naomi; Hara, Hidenori; Nezu, Kenji; Mikami, Tetsuo; Saegusa, Makoto; Satoh, Yukitoshi

doi:10.3892/etm.2011.342

Cited by 9 publications

(3 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Online supplemental table 2 illustrates the major studies 20 21 35 23 24 25 26 which have explored the impact of underlying UIP for patients who undergo major lung resection for NSCLC. Despite having a variable prevalence, some groups reporting up to 13%, 19 UIP is consistently recognised as a significant independent negative prognostic factor in terms of postoperative pulmonary complications, in-hospital mortality and overall survival ( online supplemental table 2 ).…”

Section: Discussionmentioning

confidence: 99%

Lung cancer resection in patients with underlying usual interstitial pneumonia: a meta-analysis

et al. 2023

View full text Add to dashboard Cite

ObjectivePatients with lung cancer with underlying idiopathic pulmonary fibrosis and usual interstitial pneumonia (UIP) pattern on CT represent a very high-risk group in terms of postoperative UIP acute exacerbations (AEs) and in-hospital mortality. We sought to investigate the outcomes in these patients.MethodsWe carried out a meta-analysis, searching four international databases from 1 January 1947 to 27 April 2022, for studies in any language reporting on the acute postoperative outcomes of patients with lung cancer undergoing surgical resection with underlying UIP (the primary outcome). Random effects meta-analyses (DerSimonian and Laird) were conducted. We analysed the difference in incidence of postoperative AE as well as the difference in long-term overall survival among subpopulations. These were stratified by the extent of surgical resection, with meta-regression testing (uniivariate and multivariate) according to the stage of disease, operative decision making and country of origin. This study was registered with PROSPERO (CRD42022319245).ResultsThe overall incidence of AE of UIP postoperatively from 10 studies (2202 patients) was 14.6% (random effects model, 95% CI 9.8 to 20.1, I2=74%). Sublobar resection was significantly associated with a reduced odds of postoperative AE (OR 0.521 (fixed effects model), 95% CI 0.339 to 0.803, p=0.0031, I2=0%). The extent of resection was not significantly associated with overall survival following lung cancer resection in UIP patients (HR for sublobar resection 0.978 (random effects model), 95% CI 0.521 to 1.833, p=0.9351, I2=71%).ConclusionsWith appropriate implementation of perioperative measures such as screening for high-risk cases, appropriate use of steroids, antifibrotics and employing sublobar resection in select cases, the risk of local recurrence versus in-hospital mortality from AEUIP can be balanced and long-term survival can be achieved in a super-selected group of patients. Further investigation in the form of a randomised study is warranted.

show abstract

Section: Discussionmentioning

confidence: 99%

Lung cancer resection in patients with underlying usual interstitial pneumonia: a meta-analysis

et al. 2023

View full text Add to dashboard Cite

show abstract

“…For thoracic surgeons, postoperative AE is the most critical postoperative complication in ILD patients with lung cancer and is challenging to manage. Several studies have identified predictors of postoperative AE, including advanced lung cancer, lack of postoperative steroid use, postoperative episode of inflammation, male sex, KL-6 level, HRCT pattern, predicted vital capacity, history of AE, surgical procedure [ 2 , 9 ], general anesthesia [ 10 ], and perioperative blood transfusion [ 11 ]. However, the results of these retrospective studies need to be confirmed for reproducibility.…”

Section: Discussionmentioning

confidence: 99%

Impact of partial pressure of arterial oxygen and radiologic findings on postoperative acute exacerbation of idiopathic interstitial pneumonia in patients with lung cancer

Azuma,

Sakamoto,

Homma

et al. 2023

Surg Today

Self Cite

View full text Add to dashboard Cite

Purpose To establish accurate diagnostic criteria and predictors of treatment response for postoperative acute exacerbation (AE) in patients with lung cancer and idiopathic interstitial pneumonia (IIP). Methods Among 93 patients with IIP who underwent surgery for lung cancer, suspected postoperative AE developed in 20 (21.5%). Patients were divided into a progressive AE group, comprising patients with bilateral alveolar opacities and decreasing PaO2 ≥ 10 mmHg (n = 5); an incipient AE group, comprising patients with unilateral alveolar opacities and decreasing PaO2 ≥ 10 mmHg (n = 10); and an indeterminate AE group, comprising patients with alveolar opacities but decreasing PaO2 < 10 mmHg (n = 5). Results The progressive AE group had significantly higher 90-day mortality (80%) than the incipient AE group (10%, P = 0.017) or the indeterminate AE group (0%, P = 0.048). Bilateral opacities may indicate advanced AE and poor prognosis, whereas unilateral opacities may indicate an early stage of AE and a good prognosis. PaO2 < 10 mmHg may indicate conditions other than AE. Conclusions In patients with lung cancer and IIP, decreasing PaO2 and HRCT findings may allow for the initiation of rapid and accurate treatment strategies for postoperative AE.

show abstract

“…The prediction and prevention of postoperative AE is quite important. Several reports suggest that the following items could be predictors of postoperative AE; patient age, the duration of postoperative drainage and intraoperative fluid balance [ 16 – 18 ], typical honeycombing and possible honeycombing patterns on the chest CT findings [ 19 ], and the I/M ratio, which is the ratio of the peak standardized uptake value (SUV) of the interstitial lung disease area to the mean SUV of the mediastinum [ 20 ]. Although medications are used to prevent postoperative AE of ILD [ 5 , 21 ], no evidence for prophylaxis has yet been established.…”

Section: Discussionmentioning

confidence: 99%

Effect of collagen vascular disease-associated interstitial lung disease on the outcomes of lung cancer surgery

et al. 2017

View full text Add to dashboard Cite

PurposeThis study compared the effect of collagen vascular disease-associated interstitial lung disease (CVD-ILD) with that of idiopathic interstitial pneumonias (IIPs) on the outcomes of lung cancer surgery.MethodsThis study retrospectively reviewed the medical records of patients who underwent surgery for non-small cell lung cancer (NSCLC) and compared the data of 16 patients with CVD-ILD with those of 70 patients with IIPs. The patterns of interstitial lung disease (ILD) on chest computed tomography were classified into usual interstitial pneumonia (UIP) and non-specific interstitial pneumonia (NSIP) patterns.ResultsThe numbers of UIP and NSIP patterns were 10 (62.5%) and 6 (37.5%) patients in CVD-ILD group, and 62 (88.6%) and 8 (11.4%) patients in IIPs group, respectively. A postoperative acute exacerbation (AE) appeared in 1 patient (6.3%) in the CVD-ILD group and 6 patients (8.6%) in the IIPs group. No significant differences in the incidence of postoperative AE and mortalities were observed between the two groups. The five-year overall survival rates of the CVD-ILD and IIPs groups were 37.5 and 49.2%, respectively.ConclusionsSurgery for NSCLC in CVD-ILD patients appear to cause no increase in postoperative AE and mortality in comparison to that seen in IIPs patients. Similar to IIPs, CVD-ILD might therefore affect the prognosis of resected NSCLC.

show abstract

Prediction of postoperative exacerbation of interstitial pneumonia in patients with lung cancer and interstitial lung disease

Cited by 9 publications

References 9 publications

Lung cancer resection in patients with underlying usual interstitial pneumonia: a meta-analysis

Lung cancer resection in patients with underlying usual interstitial pneumonia: a meta-analysis

Impact of partial pressure of arterial oxygen and radiologic findings on postoperative acute exacerbation of idiopathic interstitial pneumonia in patients with lung cancer

Effect of collagen vascular disease-associated interstitial lung disease on the outcomes of lung cancer surgery

Contact Info

Product

Resources

About