ArticleInternational journal of clinical oncology2026
Efficacy of a new surgical indicator for lung cancer with interstitial lung disease based on the gender-age-physiology staging system.
Article in International journal of clinical oncology, 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
backgroundSelecting the optimal surgical strategy for lung cancer patients with interstitial lung disease (ILD) remains difficult. This study evaluated the prognostic value of a newly proposed surgical indicator-the predicted ILD Gender-Age-Physiology (GAP) stage-which incorporates predicted postoperative pulmonary function into the conventional ILD-GAP stage.
methodsThis study retrospectively analyzed 125 patients with clinical stage 1 lung cancer and ILD who underwent surgery during 2011-2023. Postoperative outcomes were compared according to surgical procedure and predicted ILD-GAP stage.
resultsThe 5-year overall survival (OS) rate was markedly superior in patients who underwent anatomical resection with a predicted ILD-GAP stage ≤ 2 than in those who underwent wedge resection (75.0% vs. 21.3%, p < 0.001). In contrast, survival did not differ between anatomical resection with a predicted ILD-GAP stage 3 and wedge resection (27.8% vs. 21.3%, p = 0.934). Multivariate analysis identified diffusing capacity of carbon monoxide (p = 0.043), anatomical resection with a predicted ILD-GAP stage ≤ 2 (p = 0.009), and pathological stage 1 (p = 0.035) as independent predictors of prognosis. Furthermore, the predicted ILD-GAP stage provided superior prognostic accuracy for 5-year OS compared with the original ILD-GAP stage (area under the curve: 0.735 vs. 0.653; p = 0.040).
conclusionsThe proposed surgical indicator enhanced prognostic stratification in lung cancer patients with ILD. In particular, anatomical lung resection in patients with a predicted ILD-GAP stage ≤ 2 was identified as an independent favorable prognostic factor for 5-year OS, highlighting the importance of surgical planning.
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