Abstract
BACKGROUND: Lung cancer with interstitial pneumonia is known to be a refractory disease. We explored whether systemic inflammatory response markers are associated with outcomes in these patients. METHODS: The participants of this multicenter retrospective study, consisting of 17 medical institutions, were treatment-naïve patients with lung cancer combined with interstitial pneumonia who underwent surgical resection between 2012 and 2017. We reviewed clinicopathologic characteristics, including systemic inflammatory response markers, and examined the relationship between these characteristics and postoperative survival. RESULTS: According to the inclusion criteria, the final cohort consisted of 181 patients. Among preoperative systemic inflammatory response markers, the C-reactive protein-to-albumin ratio was an independent prognostic factor in multivariable analysis (hazard ratio, 1.71; P = .018). We examined whether the C-reactive protein-to-albumin ratio could be a determining factor in selecting surgical procedures (wedge resection or segmentectomy/lobectomy) preoperatively for patients with early-stage lung cancer. Although not statistically significant, there is a trend that the C-reactive protein-to-albumin ratio can be a possible determining factor in selecting surgical procedures. CONCLUSIONS: Our results indicate that the C-reactive protein-to-albumin ratio is an independent prognostic factor for overall survival in treatment-naïve patients with lung cancer combined with interstitial pneumonia.