KEY TAKEAWAYS
- The study aimed to investigate the impact of mild and advanced interstitial pneumonia and emphysema on prognosis and AEIP in patients with LC.
- Researchers noticed that even trivial and mild interstitial pneumonia and emphysema significantly impact mortality and AEIP.
Interstitial pneumonia and emphysema may complicate patients with lung cancer (LC). However, the clinical significance of trivial and mild pulmonary abnormalities remains unclear.
Yutaka Tomishima and the team aimed to investigate whether trivial and mild interstitial pneumonia and emphysema, in addition to their advanced forms, impact the prognosis and lead to acute exacerbation of interstitial pneumonia (AEIP) in patients with LC.
They performed an inclusive analysis in a retrospective cohort study conducted at a tertiary hospital, including patients with LC. Computed tomography images were evaluated using the interstitial lung abnormality (ILA) score for interstitial pneumonia, which categorized cases into no ILA, equivocal ILA, ILA, and interstitial lung disease (ILD), along with the Goddard score for emphysema. Cox analyses were conducted using the ILA and Goddard scores as the main explanatory variables, adjusting for multiple covariates.
About 1,507 patients with LC were included in the study, with 1,033 having no ILA, 160 having equivocal ILA, 174 having ILA, and 140 having ILD. In total, 474 patients (31.5%) exhibited interstitial pneumonia, and 638 (42.3%) showed emphysema. The log-rank trend test showed that survival probability was significantly better in patients with no ILA, followed by those with equivocal ILA, ILA, and ILD (P < 0.001). After adjustment, the ILA and Goddard scores remained significant variables for increased hazard ratios (HR) for mortality: no ILA (HR, 1.00: reference), equivocal ILA (HR, 1.31; 95% CI, 1.18-1.46; P < 0.001), ILA (HR, 1.71; 95% CI, 1.39-2.12; P < 0.001), ILD (HR, 2.24; 95% CI, 1.63-3.09; P < 0.001), and Goddard score (HR, 1.03; 95% CI, 1.01-1.06; P < 0.010). Moreover, both scores were associated with increased cause-specific HRs for AEIP.
The study concluded that approximately 1/3 of patients with LC had interstitial pneumonia when including trivial and mild cases. Interstitial pneumonia and emphysema, ranging from trivial to severe, significantly impact mortality and AEIP in patients with LC, highlighting the need to identify even trivial and mild cases of these pulmonary abnormalities in addition to advanced ones.
The study received no funds.
Source: https://pubmed.ncbi.nlm.nih.gov/38909185/
Tomishima Y, Kitamura A, Imai R, et al. (2024). “Deleterious impact of trivial to severe interstitial pneumonia and emphysema on mortality and acute exacerbation of interstitial pneumonia in patients with lung cancer: a retrospective cohort study.” BMC Pulm Med. 2024 Jun 22;24(1):290. doi: 10.1186/s12890-024-03105-7. PMID: 38909185.
