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Open Access 25-04-2024 | Esophageal Cancer | Original Article

Association between interstitial lung abnormality and mortality in patients with esophageal cancer

Authors: Akinori Hata, Masahiro Yanagawa, Tomo Miyata, Yu Hiraoka, Motohiro Shirae, Keisuke Ninomiya, Shuhei Doi, Kazuki Yamagata, Yuriko Yoshida, Noriko Kikuchi, Ryo Ogawa, Hiroto Hatabu, Noriyuki Tomiyama

Published in: Japanese Journal of Radiology | Issue 8/2024

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Abstract

Purpose

To investigate the relationship between interstitial lung abnormalities (ILAs) and mortality in patients with esophageal cancer and the cause of mortality.

Materials and methods

This retrospective study investigated patients with esophageal cancer from January 2011 to December 2015. ILAs were visually scored on baseline CT using a 3-point scale (0 = non-ILA, 1 = indeterminate for ILA, and 2 = ILA). ILAs were classified into subcategories of non-subpleural, subpleural non-fibrotic, and subpleural fibrotic. Five-year overall survival (OS) was compared between patients with and without ILAs using the multivariable Cox proportional hazards model. Subgroup analyses were performed based on cancer stage and ILA subcategories. The prevalences of treatment complications and death due to esophageal cancer and pneumonia/respiratory failure were analyzed using Fisher’s exact test.

Results

A total of 478 patients with esophageal cancer (age, 66.8 years ± 8.6 [standard deviation]; 64 women) were evaluated in this study. Among them, 267 patients showed no ILAs, 125 patients were indeterminate for ILAs, and 86 patients showed ILAs. ILAs were a significant factor for shorter OS (hazard ratio [HR] = 1.68, 95% confidence interval [CI] 1.10–2.55, P = 0.016) in the multivariable Cox proportional hazards model adjusting for age, sex, smoking history, clinical stage, and histology. On subgroup analysis using patients with clinical stage IVB, the presence of ILAs was a significant factor (HR = 3.78, 95% CI 1.67–8.54, P = 0.001). Subpleural fibrotic ILAs were significantly associated with shorter OS (HR = 2.22, 95% CI 1.25–3.93, P = 0.006). There was no significant difference in treatment complications. Patients with ILAs showed a higher prevalence of death due to pneumonia/respiratory failure than those without ILAs (non-ILA, 2/95 [2%]; ILA, 5/39 [13%]; P = 0.022). The prevalence of death due to esophageal cancer was similar in patients with and without ILA (non-ILA, 82/95 [86%]; ILA 32/39 [82%]; P = 0.596).

Conclusion

ILAs were significantly associated with shorter survival in patients with esophageal cancer.
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Metadata
Title
Association between interstitial lung abnormality and mortality in patients with esophageal cancer
Authors
Akinori Hata
Masahiro Yanagawa
Tomo Miyata
Yu Hiraoka
Motohiro Shirae
Keisuke Ninomiya
Shuhei Doi
Kazuki Yamagata
Yuriko Yoshida
Noriko Kikuchi
Ryo Ogawa
Hiroto Hatabu
Noriyuki Tomiyama
Publication date
25-04-2024
Publisher
Springer Nature Singapore
Published in
Japanese Journal of Radiology / Issue 8/2024
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-024-01563-x