Journal Article

Survival analysis in lung cancer patients with interstitial lung disease

Tyrrell, Pascal N., Wang, Stella, Alomaish, Hassan, Oikonomou, Anastasia, Ung, Yee, Zahra, Saly Abo

2021

Overview

Lung cancer patients with interstitial lung disease (ILD) are prone for higher morbidity and mortality and their treatment is challenging. The purpose of this study is to investigate whether the survival of lung cancer patients is affected by the presence of ILD documented on CT. 146 patients with ILD at initial chest CT were retrospectively included in the study. 146 lung cancer controls without ILD were selected. Chest CTs were evaluated for the presence of pulmonary fibrosis which was classified in 4 categories. Presence and type of emphysema, extent of ILD and emphysema, location and histologic type of cancer, clinical staging and treatment were evaluated. Kaplan-Meier estimates and Cox regression models were used to assess survival probability and hazard of death of different groups. P value < 0.05 was considered significant. 5-year survival for the study group was 41% versus 48% for the control group (log-rank test p = 0.0092). No significant difference in survival rate was found between the four different categories of ILD (log-rank test, p = 0.195) and the different histologic types (log-rank test, p = 0.4005). A cox proportional hazard model was used including presence of ILD, clinical stage and age. The hazard of death among patients with ILD was 1.522 times that among patients without ILD (95%CI, p = 0.029). Patients with lung cancer and CT evidence of ILD have a significantly shorter survival compared to patients with lung cancer only. Documenting the type and grading the severity of ILD in lung cancer patients will significantly contribute to their challenging management.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Aged / Aged, 80 and over / Biology and Life Sciences / Canada / Cancer therapies / Care and treatment / Chest / Complications and side effects / Emphysema / Evaluation / Female / Fibrosis / Gender / Health hazards / Health sciences / Health services / Histology / Humans / Lung cancer / Lung diseases / Lung diseases, Interstitial / Lung Diseases, Interstitial - mortality / Lung Diseases, Interstitial - pathology / Lung Diseases, Interstitial - therapy / Lung Neoplasms - diagnostic imaging / Lung Neoplasms - mortality / Lung Neoplasms - pathology / Lung Neoplasms - therapy / Male / Medical imaging / Medical prognosis / Medicine and Health Sciences / Middle Aged / Morbidity / Mortality / Patient outcomes / Patients / Prognosis / Pulmonary fibrosis / Pulmonary Fibrosis - diagnostic imaging / Pulmonary Fibrosis - mortality / Pulmonary Fibrosis - pathology / Pulmonary Fibrosis - therapy / Radiation therapy / Rank tests / Regression analysis / Regression models / Retrospective Studies / Skin cancer / Squamous cell carcinoma / Statistical analysis / Statistical models / Survival / Survival analysis / Survival Rate / Tomography, X-Ray Computed