Clinical Impact of Interstitial Pneumonia Following Surgery for Lung Cancer

Abstract

Background: Operative morbidity in patients with lung cancer associated with perioperative interstitial pneumonia (IP) has emerged as a serious problem. Patients and Methods: We studied the clinical impact of perioperative related IP in 11 patients (IP group: 7 preoperative known, 4 acute onset) of 473 lung cancer patients who received a pulmonary resection. The IP group was compared to the remaining 462 patients (non-IP group). Demographic data, clinical presentation, and serum KL-6 levels were compared. Results: There were no differences in age, gender, type of surgery, and pulmonary function except for % DLco between the non-IP and IP groups. The IP group showed a higher in-hospital mortality (n = 2: 18.3 %) than that of the non-IP group (n = 3: 0.6 %) (p < 0.005). Seven patients with underlying IP with high KL-6 levels showed an uneventful recovery. Two patients with postoperative onset of acute IP had a fatal course associated with elevation of serum KL-6 levels. Conclusions: Postoperative development IP is a serious complication with high mortality, and serial measurement of KL-6 levels is useful to assess the activity of IP.

Key words

Lung cancer - interstitial pneumonia - acute interstitial pneumonia - adult respiratory distress syndrome (ARDS)

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