427P Quantitative severity of pulmonary emphysema as a prognostic factor for recurrence in patients with surgically resected non-small cell lung cancer

Abstract

Background Pulmonary emphysema is a major component of chronic obstructive pulmonary disease and lung cancer. However, the prognostic significance of quantitative emphysema severity in patients with lung cancer is unclear. Methods We quantified emphysema severity of whole lung and regional lobe using chest computed tomography-based automatic software in 45 patients (36 males and 9 females; mean age of 68.0) with surgically resected non-small cell lung cancer. Predicting factors for recurrence were investigated using Cox proportional hazards model. The recurrence-free survival was compared after dichotomization of patients according to the whole lung emphysema severity. Results The mean percent ratio of emphysema volume/whole lung volume was 1.21 62.04. Regional lobar emphysema severity was highest in right middle lobe (1.93 6 5.36), followed by right upper (1.35 6 2.50), left upper (1.34 6 2.12), left lower (1.05 6 2.52), and right lower lobe (0.78 6 2.28). Emphysema severity of whole lung (hazard ratio, 1.36; 95% confidence interval, 1.06 - 1.73) and stage III (hazard ratio, 6.17; 95% confidence interval, 1.52 - 25.0) were independent predictors of recurrence after adjustment for age, sex, smoking status, and forced expiratory volume in 1 second. The median recurrence-free survival of low emphysema and high emphysema group were 30.1 months and 22.0 months, respectively. Conclusions Although degree of emphysema was relatively low in this study population, quantitative emphysema severity of whole lung is associated with recurrence in patients with surgically resected non-small cell lung cancer. Legal entity responsible for the study N/A Funding N/A Disclosure All authors have declared no conflicts of interest.