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. 2023 Oct 30;12(21):6858.
doi: 10.3390/jcm12216858.

Radiologic Progression of Interstitial Lung Abnormalities following Surgical Resection in Patients with Lung Cancer

Yoon Joo Shin  1 , Jeong Geun Yi  1 , Mi Young Kim  1 , Donghee Son  2 , Su Yeon Ahn  1
Affiliations

Radiologic Progression of Interstitial Lung Abnormalities following Surgical Resection in Patients with Lung Cancer

Yoon Joo Shin et al. J Clin Med. .

Abstract

In this study, we aimed to assess the prevalence of interstitial lung abnormalities (ILAs) and investigate the rates and risk factors associated with radiologic ILA progression among patients with lung cancer following surgical resection. Patients who underwent surgical resection for lung cancer at our institution from January 2015 to December 2020 were retrospectively evaluated and grouped according to their ILA status as having no ILAs, equivocal ILAs, or ILAs. Progression was determined by simultaneously reviewing the baseline and corresponding follow-up computed tomography (CT) scans. Among 346 patients (median age: 67 (interquartile range: 60-74) years, 204 (59.0%) men), 22 (6.4%) had equivocal ILAs, and 33 (9.5%) had ILAs detected upon baseline CT. Notably, six patients (6/291; 2.1%) without ILAs upon baseline CT later developed ILAs, and 50% (11/22) of those with equivocal ILAs exhibited progression. Furthermore, 75.8% (25/33) of patients with ILAs upon baseline CT exhibited ILA progression (76.9% and 71.4% with fibrotic and non-fibrotic ILAs, respectively). Multivariate analysis revealed that ILA status was a significant risk factor for ILA progression. ILAs and equivocal ILAs were associated with radiologic ILA progression after surgical resection in patients with lung cancer. Hence, early ILA detection can significantly affect clinical outcomes.

Keywords: computed tomography; interstitial lung abnormalities; lung cancer; progression; surgical resection.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of patient selection. CT, computed tomography; ILA, interstitial lung abnormality; ILD, interstitial lung disease.
Figure 2
Figure 2
Baseline and 4-year follow-up chest computed tomography images Baseline (a,c,e) and 4-year follow-up (b,d,f) chest CT images in the upper (a,b), middle (c,d), and lower (e,f) lung zones of a 56-year-old, male current smoker with a 60 pack-year smoking history. The baseline CT reveals subpleural reticulation and mild traction bronchiolectasis in both lungs, suggesting the presence of fibrotic ILAs. A 1.5 cm-sized nodule (arrow) was identified in the right upper lobe and confirmed as adenocarcinoma (a). The patient underwent right upper lobe lobectomy and adjuvant chemotherapy with cisplatin and paclitaxel. The 4-year follow-up CT reveals increased subpleural reticulation, traction bronchiectasis, and honeycombing (box), predominantly in lower lung zones, indicating ILA progression.
See this image and copyright information in PMC

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