Risk factors for postop acute exacerbation in patients with lung cancer with ILD identified

By identifying potential risk factors for postoperative acute exacerbation (AE), such as poor performance status (PS), low forced vital capacity (FVC), honeycombing on imaging, and high hemoglobin A1c (HbA1c) levels, clinicians can take appropriate precautions and develop personalized strategies to mitigate the risk of complications, according to a study.

The study retrospectively evaluated 68 patients with lung cancer and interstitial lung disease (ILD) who had undergone lung resection. The patients were divided into 2 groups: those who had developed postoperative AE within 30 days after resection and those who had not.

The incidence of postoperative AEs among patients was 11.8%. Through univariate analysis, the researchers identified several factors that were significantly associated with postoperative AE, including PS, the presence of honeycombing on imaging, FVC, and high HbA1c levels without comorbidities.

Patients were divided into 2 groups based on cutoff levels determined by receiver operating characteristic curves. An analysis showed that the rates of patients without postoperative AE significantly differed between groups. This suggests that a combination of poor PS, low FVC, honeycombing on imaging, and a high preoperative HbA1c level may increase the likelihood of postoperative AE in lung cancer patients with ILD.

The study found that preoperative comorbidities other than ILD were not significant risk factors for postoperative AE in patients with lung cancer and ILD.

The authors concluded that this highlights the importance of considering ILD-specific factors when assessing the risk of complications following lung resection.

Reference
Kato T, Miyoshi S, Hamada C, et al. Associations between Comorbidities and Acute Exacerbation of Interstitial Lung Disease after Primary Lung Cancer Surgery. Acta Med Okayama. 2023 Jun;77(3):301-309. doi: 10.18926/AMO/65495. PMID: 37357631.