Goga Alice, Fourdrain Alex, Habert Paul, Nguyen Ngoc Anh Thu, Bermudez Julien, Mogenet Alice, Simon Eléonore, Gouton Etienne, Tomasini Pascale, Thomas Pascal Alexandre, Greillier Laurent, Pluvy Johan
Service d'oncologie multidisciplinaires et innovations thérapeutiques, Département de Pneumologie, Hôpital Nord, AP-HM, Marseille, France; Aix Marseille Université, Marseille, France.
Service de chirurgie thoracique, transplantations pulmonaires et maladies de l'œsophage, Hôpital Nord, AP-HM, Marseille, France; Aix Marseille Université, Marseille, France.
Respir Med Res. 2024 Nov;86:101126. doi: 10.1016/j.resmer.2024.101126. Epub 2024 Jul 30.
Interstitial lung disease (ILD) is a known risk factor for lung cancer (LC). However, the surgical risk of LC in patients with ILD remains unclear. Therefore, we conducted a single-center retrospective study to assess clinical features and outcomes of LC population who underwent surgery with or without ILD.
Patients who underwent surgery for LC between January 2006 and June 2023 in our center were assessed using data extracted from the nationwide EPITHOR thoracic surgery database. Suspicion of ILD was based on patients' records. Confirmation of ILD was then made on the patient's medical and radiological history. Patients were classified according to the pattern of ILD. The study aimed to describe the outcomes after lung cancer resection in patients with confirmed LC-ILD group compared to those without ILD (LC-non-ILD): post-operative complications, disease-free survival (DFS) and overall survival (OS). A subgroup analysis was also performed on patients with idiopathic pulmonary fibrosis and lung cancer (LC-IPF).
4073 patients underwent surgery for LC at Assistance Publique des Hôpitaux de Marseille between January 2006 and June 2023. Of these, 4030 were in the LC-non-ILD group and 30 were LC-ILD patients. In the LC-ILD group, the predominant CT scan pattern was probable UIP (50 %). OS was not significantly lower in the LC-ILD group (45 months versus 84 months, p = 0.068). Dyspnea and tumor size were identified as potential univariate predictors of OS. No significant differences were observed on post-operative complications or their severity. The most common post-operative complications in the LC-ILD group were prolonged air leak, respiratory failure, or pneumonia. 13 patients had cancer recurrence in the LC-ILD group.
Our study provides a comprehensive analysis of a LC-ILD population features and outcome when undergoing surgery for LC. Patients with LC-ILD appeared to have a reduced OS compared with LC-non-ILD. Further investigations with larger prospective studies could be useful to confirm and develop these preliminary findings.
间质性肺疾病（ILD）是肺癌（LC）的已知危险因素。然而，ILD患者行LC手术的风险仍不明确。因此，我们进行了一项单中心回顾性研究，以评估接受或未接受ILD手术的LC患者群体的临床特征和预后。
使用从全国性的EPITHOR胸外科数据库中提取的数据，对2006年1月至2023年6月期间在本中心接受LC手术的患者进行评估。对ILD的怀疑基于患者记录。然后根据患者的病史和影像学检查确诊ILD。根据ILD模式对患者进行分类。本研究旨在描述确诊为LC-ILD组的患者与未患ILD（LC-非ILD）的患者在肺癌切除术后的预后：术后并发症、无病生存期（DFS）和总生存期（OS）。还对特发性肺纤维化合并肺癌（LC-IPF）患者进行了亚组分析。
2006年1月至2023年6月期间，4073例患者在马赛公立医院接受了LC手术。其中，4030例属于LC-非ILD组，30例为LC-ILD患者。在LC-ILD组中，主要的CT扫描模式可能是普通型间质性肺炎（UIP）（50%）。LC-ILD组的OS没有显著降低（45个月对84个月，p = 0.068）。呼吸困难和肿瘤大小被确定为OS的潜在单因素预测指标。术后并发症或其严重程度未观察到显著差异。LC-ILD组最常见的术后并发症是持续漏气、呼吸衰竭或肺炎。LC-ILD组有13例癌症复发。
我们的研究对LC-ILD患者群体在接受LC手术时的特征和预后进行了全面分析。与LC-非ILD患者相比，LC-ILD患者的OS似乎有所降低。进一步开展更大规模的前瞻性研究可能有助于证实和拓展这些初步发现。
