WCLC 2025 - Posters & ePosters-EP.06.84 Impact of Preoperative Brain Natriuretic Peptide Levels on Postoperative Outcomes in Lung Cancer Patients

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This retrospective study examined the impact of preoperative brain natriuretic peptide (BNP) levels on postoperative outcomes in 430 patients undergoing curative resection for non-small cell lung cancer at Hokkaido University Hospital. BNP, traditionally a cardiac biomarker, has recently been explored as a potential cancer biomarker but its role in lung cancer surgery patients remains unclear.<br /><br />Patients with BNP levels above 18.5 pg/ml (Japanese heart failure guideline cutoff) were older and had a higher prevalence of cardiac comorbidities such as ischemic heart disease and interstitial pneumonia. No significant correlation was found between BNP levels and tumor characteristics, including tumor diameter, pathological stage, or SUVmax, suggesting BNP does not reflect tumor progression. <br /><br />Importantly, elevated preoperative BNP levels were associated with poorer overall survival (OS) post-surgery, even after propensity score matching for confounders such as age, cardiac risk, and cancer stage. The difference in outcome was driven primarily by non-cancer-related mortality rather than cancer recurrence, indicating BNP may reflect a patient’s general health and comorbidity burden rather than lung cancer severity itself.<br /><br />Multivariate analysis showed elevated BNP approached but did not reach statistical significance as an independent prognostic factor, whereas factors like male sex and pathological stage II had a stronger association with survival.<br /><br />The study concludes that preoperative BNP may serve as a useful biomarker to evaluate the overall physiological condition and predict postoperative prognosis in lung cancer surgery patients. However, its link to tumor biology or lung cancer progression is unproven. Further research is needed to clarify whether BNP levels can guide perioperative management or postoperative surveillance in lung cancer.<br /><br />In summary, while elevated preoperative BNP indicates higher risk for poorer postoperative survival due to non-oncologic causes, BNP does not appear directly related to tumor burden or relapse in lung cancer surgery patients.

Asset Subtitle

Shinya Otsuka

Meta Tag

Speaker Shinya Otsuka

Topic Pathology and Biomarkers

Keywords

brain natriuretic peptide

BNP

non-small cell lung cancer

preoperative biomarker

postoperative outcomes

overall survival

cardiac comorbidities

lung cancer surgery

prognostic factor

Hokkaido University Hospital