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Updated: Apr 22, 2026

Diaphragmatic Ultrasound in Adults: Image Acquisition and Interpretation
Published on: January 31, 2025
Association between preoperative diaphragmatic dome height for overall survival in patients with lung cancer and
Masaya Noguchi1,2, Yuji Higashimoto3, Toshiki Takemoto4
1Department of Rehabilitation, Kindai University Hospital, Sakai City, Osaka, 590-0197, Japan. n.masaya@med.kindai.ac.jp.
Background:
To investigate the relationship between preoperative diaphragmatic dome height (DDH), measured on chest radiographs, and postoperative overall survival (OS) and disease-specific survival (DSS) due to respiratory-related deaths in patients with lung cancer and obstructive ventilatory disorder (OVD).
Methods:
This single-center retrospective study included 302 patients with lung cancer and OVD who underwent lobectomy between 2017 and 2024. DDH was measured on chest radiographs 1 month preoperatively, and the patients were divided into the low DDH (lower than the first quartile, 18.8 mm) and high DDH (≥ 18.8 mm) groups. The associations of DDH with OS and DSS were evaluated using Cox proportional hazards models and Fine-Gray competing risk analysis, respectively. Kaplan-Meier curves and log-rank tests were used for survival comparisons.
Results:
Overall, 65 patients (21%) died postoperatively. Cox proportional hazards and Fine-Gray analyses indicated that DDH (hazard ratio: 2.10, 95% confidence interval [CI]: 1.22-3.61, p < 0.01; subdistribution hazard ratio: 2.50, 95% CI: 1.14-5.45, p < 0.05) was an independent prognostic factor for 3-year OS and DSS. Furthermore, survival curve analysis demonstrated that the low DDH group had significantly lower 3-year OS (70% vs 85%, p < 0.01) and 3-year DSS (80% vs 92%, p < 0.01) compared with the high DDH group.
Conclusions:
DDH is an independent prognostic factor for OS and DSS in patients with lung cancer and OVD, suggesting that it can serve as a novel physiological marker for long-term prognosis.
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