WCLC 2025 - Posters & ePosters-EP.07.06 Preserved Ratio Impaired Spirometry Are Associated With Poor Postoperative Outcomes in Clinical Stage I Non-Small Lung Cancer

EP.07.06 Preserved Ratio Impaired Spirometry Are Associated With Poor Postoperative Outcomes in Clinical Stage I Non-Small Lung Cancer

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This study by Shiotani et al. investigates the impact of Preserved Ratio Impaired Spirometry (PRISm) on postoperative outcomes in patients with clinical stage I non-small cell lung cancer (NSCLC). PRISm is characterized by a normal FEV1/FVC ratio (>0.7) but reduced FEV1 (<80% predicted), distinguishing it from chronic obstructive pulmonary disease (COPD). While PRISm is known to increase mortality risk from cardiovascular and respiratory diseases, its role in lung cancer surgery outcomes was previously unclear.<br /><br />The retrospective study analyzed 703 patients with stage I NSCLC undergoing lung resection from 2013 to 2021, excluding those with restrictive spirometric patterns or COPD. Patients were grouped into normal spirometry (n=420) and PRISm (n=23). Key differences included higher male prevalence (78% vs. 44%) and more coronary artery disease in the PRISm group. Lung cancer types and surgical procedures were similar between groups.<br /><br />Postoperative complications occurred at comparable rates; however, PRISm patients demonstrated significantly worse 3-year recurrence-free survival (RFS) and overall survival (OS). Specifically, PRISm patients had higher cancer recurrence (22% vs. 7.9%) and a trend toward more adjuvant therapy usage. The study suggests PRISm's association with cardiovascular comorbidity may contribute to poorer short-term postoperative outcomes.<br /><br />The authors conclude that PRISm is an important risk factor for adverse outcomes after surgery in early-stage NSCLC. Given its impact on postoperative prognosis, patients with PRISm may benefit from more intensive pre- and postoperative management analogous to strategies for COPD or restrictive lung disease. This highlights the need to consider PRISm status during lung cancer treatment planning to improve survival outcomes.

Asset Subtitle

Toshio Shiotani

Meta Tag

Speaker Toshio Shiotani

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

Preserved Ratio Impaired Spirometry

PRISm

non-small cell lung cancer

NSCLC

postoperative outcomes

lung resection

spirometry

recurrence-free survival

overall survival

cardiovascular comorbidity