ArticleGeneral thoracic and cardiovascular surgery2026
Unilateral upper-lung field pulmonary fibrosis radiologically consistent with pleuroparenchymal fibroelastosis after lung cancer surgery: prolonged pleural effusion and pleural thickening as early postoperative indicators.
Article in General thoracic and cardiovascular surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundUnilateral upper-lung field pulmonary fibrosis (upper-PF) can occur on the operative side after lung cancer surgery. It is reportedly associated with pleural effusion at 6 months post-surgery (PE-6mo), but the perioperative risk factors for PE-6mo and the cumulative incidence of upper-PF remain unclear.
methodsWe retrospectively reviewed all patients with lung cancer who underwent radical surgical resection between 2008 and 2016. Perioperative characteristics were compared based on the presence of PE-6mo. The cumulative incidence of upper-PF in patients with PE-6mo was estimated using a competing risk analysis.
resultsOf the 587 patients, 160 (27.2%) had PE-6mo. Multivariate analysis identified age > 70 years, body mass index < 22, thoracotomy, lobectomy, pulmonary apical cap, and adjuvant chemotherapy as independent risk factors for PE-6mo. Among 115 patients evaluable by chest CT for 2 years, 25 (21.7%) subsequently developed upper-PF (upper-PF group), while 90 did not (non-upper-PF group). The 3-, 5-, and 10-year cumulative incidences of upper-PF were 11.5%, 16.4%, and 24.6%. The upper-PF group more commonly had prolonged pleural effusion at 2 years than the non-upper-PF group (21/25 vs. 51/90, p = 0.018). Furthermore, pleural thickening was already evident at 6 months in the upper-PF group (15/25 vs. 18/90, P < 0.001) and thereafter. For patients with pleural thickening at 6 months, the 3-, 5-, and 10-year cumulative incidences of upper-PF were 24.2%, 35.0%, and 51.8%.
conclusionProlonged pleural effusion with pleural thickening was a common phenomenon in patients who later developed upper-PF after surgery and may therefore be a strong postoperative indicator of upper-PF development.
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