Authors
Shunta Tsuchida, Joji Samejima, Masashi Wakabayashi, Makoto Tada, Tomohiro Miyoshi, Kenta Tane, Keiju Aokage
Published in
Journal of thoracic disease. Volume 18. Issue 9. Pages 1023. Sep 30, 2026. Epub Aug 28, 2026.
Abstract
A surgical-side pulmonary artery diameter (ssPAD) ≥23 mm has been linked to postoperative complications after lobectomy for non-small cell lung cancer (NSCLC), but its prognostic significance remains unclear. This study evaluated whether ssPAD ≥23 mm serves as an independent prognostic factor and a useful indicator for preoperative risk assessment.
We retrospectively analyzed 438 patients who underwent lobectomy for NSCLC between 2016 and 2017. Patients were classified by ssPAD: ≥23 mm (n=116) and <23 mm (n=322). Survival outcomes and clinicopathological variables were compared. The prognostic performance of ssPAD was assessed using C-statistics against main pulmonary artery diameter (MPAD) ≥28 mm and pulmonary artery-to-aorta (PA/A) ratio >1.
The ssPAD ≥23 mm group showed lower 5-year recurrence-free survival (RFS; 61% vs. 71%, P=0.047) and overall survival (OS; 69% vs. 81%, P=0.001). Lung cancer-specific mortality (24% vs. 13%, P=0.03) and non-cancer mortality (15% vs. 7.1%, P=0.042) were higher, while adjuvant therapy was less frequent due to dyspnea. In multivariable analysis, ssPAD ≥23 mm remained an independent predictor of OS [hazard ratio (HR) 1.84, 95% confidence interval (CI): 1.22-2.79, P=0.004].
Preoperative ssPAD ≥23 mm may be an independent prognostic marker after lobectomy for NSCLC and a simple computed tomography (CT)-based tool for risk stratification.
PMID:
42865797
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.
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