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Background <p>To investigate the relationship between preoperative diaphragmatic dome height (DDH), measured on chest radiographs, and postoperative overall survival (OS) and disease-specific survival (DSS) due to respiratory-related deaths in patients with lung cancer and obstructive ventilatory disorder (OVD).</p> Methods <p>This single-center retrospective study included 302 patients with lung cancer and OVD who underwent lobectomy between 2017 and 2024. DDH was measured on chest radiographs 1&#xa0;month preoperatively, and the patients were divided into the low DDH (lower than the first quartile, 18.8&#xa0;mm) and high DDH (≥ 18.8&#xa0;mm) groups. The associations of DDH with OS and DSS were evaluated using Cox proportional hazards models and Fine–Gray competing risk analysis, respectively. Kaplan–Meier curves and log-rank tests were used for survival comparisons.</p> Results <p>Overall, 65 patients (21%) died postoperatively. Cox proportional hazards and Fine–Gray analyses indicated that DDH (hazard ratio: 2.10, 95% confidence interval [CI]: 1.22–3.61, <i>p</i> &lt; 0.01; subdistribution hazard ratio: 2.50, 95% CI: 1.14–5.45, <i>p</i> &lt; 0.05) was an independent prognostic factor for 3-year OS and DSS. Furthermore, survival curve analysis demonstrated that the low DDH group had significantly lower 3-year OS (70% vs 85%, <i>p</i> &lt; 0.01) and 3-year DSS (80% vs 92%, <i>p</i> &lt; 0.01) compared with the high DDH group.</p> Conclusions <p>DDH is an independent prognostic factor for OS and DSS in patients with lung cancer and OVD, suggesting that it can serve as a novel physiological marker for long-term prognosis.</p>

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Association between preoperative diaphragmatic dome height for overall survival in patients with lung cancer and obstructive ventilatory disorder

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月21日

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  • Masaya Noguchi,
  • Yuji Higashimoto,
  • Toshiki Takemoto,
  • Masashi Shiraishi,
  • Hiroki Mizusawa,
  • Kengo Kanki,
  • Ryota Matsuzawa,
  • Akira Tamaki,
  • Yasuhiro Tsutani

摘要

Background

To investigate the relationship between preoperative diaphragmatic dome height (DDH), measured on chest radiographs, and postoperative overall survival (OS) and disease-specific survival (DSS) due to respiratory-related deaths in patients with lung cancer and obstructive ventilatory disorder (OVD).

Methods

This single-center retrospective study included 302 patients with lung cancer and OVD who underwent lobectomy between 2017 and 2024. DDH was measured on chest radiographs 1 month preoperatively, and the patients were divided into the low DDH (lower than the first quartile, 18.8 mm) and high DDH (≥ 18.8 mm) groups. The associations of DDH with OS and DSS were evaluated using Cox proportional hazards models and Fine–Gray competing risk analysis, respectively. Kaplan–Meier curves and log-rank tests were used for survival comparisons.

Results

Overall, 65 patients (21%) died postoperatively. Cox proportional hazards and Fine–Gray analyses indicated that DDH (hazard ratio: 2.10, 95% confidence interval [CI]: 1.22–3.61, p < 0.01; subdistribution hazard ratio: 2.50, 95% CI: 1.14–5.45, p < 0.05) was an independent prognostic factor for 3-year OS and DSS. Furthermore, survival curve analysis demonstrated that the low DDH group had significantly lower 3-year OS (70% vs 85%, p < 0.01) and 3-year DSS (80% vs 92%, p < 0.01) compared with the high DDH group.

Conclusions

DDH is an independent prognostic factor for OS and DSS in patients with lung cancer and OVD, suggesting that it can serve as a novel physiological marker for long-term prognosis.