P2.17-29 Is Collagen Vascular Disease-Associated Interstitial Lung Disease a High Risk for Lung Cancer Surgery?

Abstract

Interstitial lung disease (ILD) frequently coexists with collagen vascular disease (CVD), and most of such patients are treated with immunosuppressive agents. Although the prognosis of CVD-ILD is better than that of idiopathic interstitial pneumonias (IIPs), the effect of CVD-ILD on the outcome and postoperative complication, including acute exacerbation (AE), after lung cancer surgery are unknown. The subjects of this retrospective study were 2272 patients who underwent surgical resection of lung cancer at our institute between 2009 and 2016. We compared the characteristics, postoperative complication, and outcome of 18 patients with CVD-ILD with those of 201 Patients with IIPs. The pattern of ILD were based on chest computed tomography and classified into usual interstitial pneumonia (UIP) and the others. The numbers of UIP patterns were 7 (39%) in CVD-ILD and 77 (38%) in IIPs. Thirteen patients (72%) were taking corticosteroids and 6 patients (33%) were taking immunosuppressive agents in CVD-ILD. Although postoperative AE occurred in 6 (3%) in IIPs, there were no AE events in CVD-ILD. Female (P < 0.01), lower pack-year smoke (P = 0.04), never smoker (P = 0.04), high value of LDH (P < 0.01), and medication of corticosteroids or immunosuppressive agents (P < 0.01) were significantly more common in CVD-ILD. Although there were no significant differences on the incidents of postoperative complications and mortalities, the duration to postoperative onset of IP exacerbation in CVD-ILD were tended to be longer than IIPs (P = 0.07). There were no significant differences on the cause of death between the 2 groups.. There were no significant differences on the outcome and the incidents of postoperative complication, including AE.