Reduced area of the normal lung on high-resolution computed tomography predicts poor survival in patients with lung cancer and combined pulmonary fibrosis and emphysema.
Aged
Carcinoma, Squamous Cell
/ diagnostic imaging
Disease Progression
Emphysema
/ complications
Female
Humans
Lung
/ diagnostic imaging
Lung Neoplasms
/ diagnostic imaging
Male
Middle Aged
Multivariate Analysis
Neoplasm Staging
Predictive Value of Tests
Proportional Hazards Models
Pulmonary Fibrosis
/ complications
Radiographic Image Enhancement
Retrospective Studies
Survival Rate
Tomography, X-Ray Computed
Combined pulmonary fibrosis and emphysema
Emphysema
High-resolution computed tomography
Interstitial pneumonia
Lung cancer
Journal
Respiratory investigation
ISSN: 2212-5353
Titre abrégé: Respir Investig
Pays: Netherlands
ID NLM: 101581124
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
received:
02
07
2018
revised:
22
09
2018
accepted:
05
10
2018
pubmed:
26
11
2018
medline:
8
6
2019
entrez:
26
11
2018
Statut:
ppublish
Résumé
This study aimed to determine the radiologic predictors and clarify the clinical features related to survival in patients with combined pulmonary fibrosis and emphysema (CPFE) and lung cancer. We retrospectively reviewed the medical chart data and high-resolution computed tomography (HRCT) findings for 81 consecutive patients with CPFE and 92 primary lung cancers (70 men, 11 women; mean age, 70.9 years). We selected 8 axial HRCT images per patient, and visually determined the normal lung, modified Goddard, and fibrosis scores. Multivariate analysis was performed using the Cox proportional hazards regression model. The major clinical features were a high smoking index of 54.8 pack-years and idiopathic pulmonary fibrosis (n = 44). The major lung cancer profile was a peripherally located squamous cell carcinoma (n = 40) or adenocarcinoma (n = 31) adjacent to emphysema in the upper/middle lobe (n = 27) or fibrosis in the lower lobe (n = 26). The median total normal lung, modified Goddard, and fibrosis scores were 10, 8, and 8, respectively. TNM Classification of malignant tumors (TNM) stage I, II, III, and IV was noted in 37, 7, 26, and 22 patients, respectively. Acute exacerbation occurred in 20 patients. Multivariate analysis showed that a higher normal lung score and TNM stage were independent radiologic and clinical predictors of poor survival at the time of diagnosis of lung cancer. A markedly reduced area of normal lung on HRCT was a relevant radiologic predictor of survival.
Sections du résumé
BACKGROUND
BACKGROUND
This study aimed to determine the radiologic predictors and clarify the clinical features related to survival in patients with combined pulmonary fibrosis and emphysema (CPFE) and lung cancer.
METHODS
METHODS
We retrospectively reviewed the medical chart data and high-resolution computed tomography (HRCT) findings for 81 consecutive patients with CPFE and 92 primary lung cancers (70 men, 11 women; mean age, 70.9 years). We selected 8 axial HRCT images per patient, and visually determined the normal lung, modified Goddard, and fibrosis scores. Multivariate analysis was performed using the Cox proportional hazards regression model.
RESULTS
RESULTS
The major clinical features were a high smoking index of 54.8 pack-years and idiopathic pulmonary fibrosis (n = 44). The major lung cancer profile was a peripherally located squamous cell carcinoma (n = 40) or adenocarcinoma (n = 31) adjacent to emphysema in the upper/middle lobe (n = 27) or fibrosis in the lower lobe (n = 26). The median total normal lung, modified Goddard, and fibrosis scores were 10, 8, and 8, respectively. TNM Classification of malignant tumors (TNM) stage I, II, III, and IV was noted in 37, 7, 26, and 22 patients, respectively. Acute exacerbation occurred in 20 patients. Multivariate analysis showed that a higher normal lung score and TNM stage were independent radiologic and clinical predictors of poor survival at the time of diagnosis of lung cancer.
CONCLUSIONS
CONCLUSIONS
A markedly reduced area of normal lung on HRCT was a relevant radiologic predictor of survival.
Identifiants
pubmed: 30472091
pii: S2212-5345(18)30150-3
doi: 10.1016/j.resinv.2018.10.007
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
140-149Informations de copyright
Copyright © 2018 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.