Abstract 124P
Background
Coronary artery calcification (CAC) is a well-known cardiovascular risk factor and a reliable score to predict non-cancer survival. In the last year, the CAC score has been investigated in lung cancer (LC) screening, showing promising results in terms of mortality risk assessment. Nevertheless, its role in LC patients has still to be investigated. This study aims to evaluate the performance of a fully automated CAC scoring in predicting 5-year survival of patients who underwent surgical resection for stage I LC.
Methods
This retrospective observational study included 536 consecutive patients with stage I LC who underwent preoperative chest CT with a 128+ slice CT scanner followed by surgical resection, between 2011 and 2022. The CAC score was measured by a commercially available, fully automated artificial intelligence (AI) software. CAC score was categorized into three validated risk categories: <100; 100-399; and ≥400. The primary outcome was the 5-year overall survival rate.
Results
A total of 110 (20.5%) patients had a CAC score ≥400, 149 (27.8%) of 100-399, and 277 (51.7%) <100. Male smokers had the highest CAC values: 32% (88/273) ≥400 and 36% (97/273) <100, while only 17% (5/29) of non-smoking males had CAC ≥400. Females had lower CAC values compared to males both in smokers and in non-smokers: only 10% (17/167) ≥400 in smoking females and 0% in non-smoking females. After a median follow-up of 3.7 years, the 5-year survival was 80.3% overall, 84.1% in CAC<100, 78.6% in CAC 100-399, and 73.3% in CAC >=400, with a statistically significant poorer outcome in patients with higher CAC (p=0.0072).
Conclusions
We observed that CAC score was a risk factor associated with gender and smoking status and predicted the 5-year overall survival in patients with resected stage I LC. These results open new prospects for prevention of non-cancer mortality in early-stage LC patients.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.