Chronic Progression of Lung Cancer Recurrence After Surgery: Warning Role of Postoperative Pneumonia

Abstract Background: The association between the process of postoperative pneumonia and lung cancer recurrence remains elusive in lung cancer surgery. We investigated the association between postoperative pneumonia and lung cancer recurrence development, emphasizing the warning role of postoperative specific pneumonia, in primary lung cancer resection patients.Methods: We assessed the occurrence of postoperative pneumonia in four to six months (PPFS), seven to twelve month (PPST), and lung cancer recurrence within one year (LRO) in 332 patients. The primary outcome was the development of PPST and LRO according to PPFS occurrence. Relevant risk factors of PPFS, PPST and LRO were identified through multivariable regression analysis.Results: During follow-up, 151 participants (45.48%) experienced PPFS outcomes. Regardless of the existing of postoperative pneumonia in one to three months (PPOT), PPFS increased the risk of PPST (OR: 2.886, 95% CI: 1.193-6.978, P<0.01 and LRO (OR: 2.793, 95% CI: 1.406- 5.552, P<0.01), and persistent PPST further increased the risk of LRO (OR:16.271, 95% CI: 6.757-39.182, P<0.001). Generalized estimating equation identified chemotherapy or targeted therapy as independent risk factors for PPFS and PPST.Conclusions: PPFS was associated with increased risk of PPST and LRO. Postoperative pulmonary inflammation assessed 4 months post-surgery also significantly influenced LRO development, indicating a need for close follow-up of lung inflammatory conditions to improve patient outcomes.