Association Between Interstitial Lung Disease and Outcomes After Lung Cancer Resection

Area of Science:

• Pulmonary Medicine
• Thoracic Surgery
• Oncology

Background:

• Interstitial lung disease (ILD) is associated with higher rates of lung cancer and increased risk of postoperative complications.
• Understanding the impact of ILD on lung resection outcomes is crucial for patient management.

Purpose of the Study:

• To investigate the effect of interstitial lung disease (ILD) on national-scale outcomes following pulmonary resection for non-small cell lung cancer.

Main Methods:

• Retrospective analysis of The Society of Thoracic Surgeons General Thoracic Surgery Database (2009-2019).
• Comparison of baseline characteristics and postoperative outcomes between patients with and without ILD.
• Multivariable logistic regression to identify risk factors for mortality, ARDS, and composite morbidity/mortality.

Main Results:

• 1.5% of patients undergoing lung resection for non-small cell lung cancer had ILD.
• Patients with ILD had higher rates of smoking, pulmonary hypertension, impaired diffusing capacity, and sublobar resections.
• ILD was associated with significantly increased postoperative mortality (5.1% vs 1.2%), ARDS (1.9% vs 0.5%), and composite morbidity/mortality (13.2% vs 7.4%).

Conclusions:

• Interstitial lung disease (ILD) is a significant risk factor for operative mortality and morbidity after lung cancer resection.
• The increased risk associated with ILD persists even in patients with normal pulmonary function.
• These findings underscore the importance of considering ILD in surgical planning and risk assessment for lung cancer patients.