Acute Exacerbation of Interstitial Pneumonia After Pulmonary Resection for Lung Cancer

Abstract

Interstitial lung diseases (ILDs) are associated with an increased risk of lung cancer. However, the contribution of anticancer therapies is unclear because these therapies including surgery may trigger acute exacerbation (AE) and are confounded by the progressive nature and poor prognoses of ILDs. We conducted a large (n = 1,763) retrospective multi-institutional study to identify the predictors of AE and to identify the predictors of long-term survival after surgical resection for lung cancer. AE occurred in 9.3 % of patients and its mortality was 43.9 %. With multivariate analysis, the following seven risk factors of AE were identified: anatomical surgical resection, male sex, history of AE, preoperative steroid use, high serum sialylated carbohydrate antigen KL-6 level, usual interstitial pneumonia appearance on CT, and reduced percent-predicted vital capacity (%VC). Unfortunately, no effective prophylactic medication could be identified.