Newly diagnosed non‐small cell lung cancer with interstitial lung abnormality: Prevalence, characteristics, and prognosis

Abstract

Background Along with the improvement of lung cancer screening implementation, the identification of interstitial lung abnormality (ILA) is increasing. Currently, there is a limited description of the oncogenic status and ILA subtypes among newly diagnosed non‐small cell lung cancer (NSCLC) patients with ILA in the Chinese population. This study aimed to investigate the prevalence, characteristics, oncogenic status and factors associated with overall survival (OS) among NSCLC patients with ILA. Methods A total of 765 newly diagnosed NSCLC cases at our hospital were reviewed and ILA was diagnosed according to the criteria of the Fleischner Society. The characteristics, clinical pathological features and OS of NSCLC patients with ILA were retrospectively analyzed. Results Of the 765 patients included in the study, 101 (13.2%) cases experienced ILA at the time of NSCLC diagnosis. Multivariate analysis revealed that ILA was more likely to be detected in NSCLC patients who were age ≥60 (OR 2.404, p = 0.001), male gender (OR 2.476, p = 0.004), and EGFR wild‐type (OR 2.035, p = 0.007). Additionally, according to the multivariate Cox model, the presence of ILA in NSCLC patients was significantly associated with a shorter OS period than those without ILA (751 days vs. 445 days, HR 0.6, p = 0.001). Following analysis, it was determined that OS in patients with usual interstitial pneumonia (UIP) was shorter than in those without UIP (HR 1.82, p = 0.037). Conclusion ILA is a common comorbidity among newly diagnosed NSCLC patients. We found that patients with EGFR wild‐type NSCLC were more likely to develop ILA. The presence of ILA, especially UIP, was significantly associated with poor NSCLC prognosis.

Automated CT quantification of interstitial lung abnormality in patients with resectable stage I non‐small cell lung cancer: Prognostic significance

“…Putman et al 7 found that participants with ILA were more likely to die of respiratory causes than were patients without ILA (HR, 2.4; p < 0.001). A Chinese study 13 also demonstrated that the presence of ILA in patients with NSCLC was significantly associated with a shorter OS than that of patients without ILA (751 days vs. 445 days, HR 0.6, p = 0.001). In patients with treatment‐naïve advanced NSCLC with ILA, the median OS was significantly shorter than that of patients without ILA (median OS: 7.2 months vs. 14.8 months; p = 0.002).…”

KRASG12C Inhibitor as a Treatment Option for Non-Small-Cell Lung Cancer with Comorbid Interstitial Pneumonia

“…HAA increased by 2.5 cm 3 (95% confidence interval [CI]: 1.8-3.3 cm 3 ) for every 10 cigarette pack years after adjusting for age, sex, and ethnicity [30]. The prevalence of ILA detected by CT has ranged from 8% to 22.8% in cohorts of smokers [31,32], and 13.2% of patients had ILA at the time of NSCLC diagnosis [33]. In a study involving patients with stage IV NSCLC, a high ILA score, which was visually evaluated, was associated with shorter survival [34].…”

Prognostic impact of interstitial lung abnormalities in lung cancer: a systematic review and meta-analysis

“…Numerous studies (5,6) indicating an increased occurrence of lung cancer and heightened pulmonary complications following cancer therapy in ILA patients. Additionally, some studies (7)(8)(9)(10)(11)(12)(13)(14) suggest that combined ILA significantly worsens the prognosis in lung cancer patients. Conversely, conflicting studies (15-18) have shown no clear correlation between ILA and survival outcome among lung cancer patients.…”