Mortality rate in chronic fibrosing idiopathic interstitial pneumonia: the role of lung cancer

Mortality rate in chronic fibrosing idiopathic interstitial pneumonia: the role of lung cancer | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Mortality rate in chronic fibrosing idiopathic interstitial pneumonia: the role of lung cancer Beatriz Morales Chacón, Lydia Abásolo Alcázar, José Luis Álvarez-Sala Walther, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5876050/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background. The coexistence of chronic fibrosing idiopathic interstitial pneumonia (cf-IIP) and lung cancer (LC) in the same patient raises many doubts regarding patient prognosis and complicates decision-making in multidisciplinary thoracic committees. Research questions. To provide new insights into the management and prognosis of patients with cf-IIP, we assessed the sociodemographic and clinical differences between patients with and without LC to evaluate their role in their mortality. Other factors were also studied. Methods. A longitudinal study was conducted from January 1, 2001, to December 31, 2020, in “XXX”. All patients who attended the interstitial lung disease multidisciplinary unit and had a medical diagnosis of cf-IIP were included. The primary outcome was all-cause mortality. The independent variable was the presence of LC. Covariates: sociodemographic, clinical, and therapeutic variables. The mortality rate (MR) was expressed per 1000 patient-years with a 95% confidence interval (CI). Cox multiple regression analysis examined the influence of LC and other covariates on mortality. The results are expressed as hazard ratios (HRs) with CIs. Results. A total of 313 patients with cf-IIP were included, with a follow‑up of 1589.6 patient‑years. There were 209 (66.8%) deaths. The MR was 131.5 (114.8-150.6), and 50% of patients died at 5.58 years from cf-IIP diagnosis. After adjusting for confounders, LC was associated with a significantly increased risk of mortality (HR: 4.11; 2.50-6.77; p = 0.000), whereas antifibrotic treatment was the only factor that decreased the risk of mortality (HR: 0.60; 0.43-0.84; p = 0.003). The prevalence of LC was 15.3%. The most common histopathological type was squamous cell carcinoma (39.6%). At diagnosis, 68.7% of LC cases were in stages III-IV. The most widely used treatment was chemotherapy and its combination (43.7%). Conclusions. Patients with cf-IIP who developed LC had a fourfold increased risk of mortality and shorter mean survival (two years versus six years) compared with those without LC. Therefore, we recommend LC screening in these patients. Pulmonology interstitial lung disease idiopathic pulmonary fibrosis usual interstitial pneumonia fibrotic nonspecific interstitial pneumonia combined pulmonary fibrosis and emphysema lung cancer Figures Figure 1 Figure 2 BACKGROUND Idiopathic pulmonary fibrosis (IPF) [ 1 ] and fibrotic nonspecific interstitial pneumonia (fNSIP) [ 2 ] are categorized as chronic fibrosing idiopathic interstitial pneumonia (cf-IIP). In this group, we included combined pulmonary fibrosis and emphysema (CPFE), which, although it is considered a type of nonclassifiable idiopathic interstitial pneumonia (IIP), shares a fibrotic character and poor prognosis with previous methods [ 3 ]. Lung cancer (LC) remains the leading cause of cancer-related mortality, with a 5-year overall survival rate of only 20% [ 4 ]. Since 1953, the association between interstitial lung disease (ILD) and LC has been recognized [ 5 ]. IPF and LC have common risk and etiological factors, such as male sex, advanced age, and a history of smoking [ 6 ]. Additionally, they share pathogenic mechanisms at the cellular, molecular, genetic, and epigenetic levels [ 7 ]. The coexistence of both diseases in the same patient raises many doubts regarding prognosis and complicates decision-making in multidisciplinary thoracic committees. We generally undertreat these patients due to the risk of acute exacerbation (AE) [ 8 ] associated with LC diagnostic and therapeutic procedures, whether with surgery [ 9 , 10 ], chemotherapy [ 11 , 12 , 13 ], molecular targets [ 14 ], immune checkpoint inhibitors [ 15 , 16 ], or stereotactic radiotherapy [ 17 ]. METHODS Objetive To provide new perspectives on the management and long-term prognosis of cf-IIP patients in clinical practice, our study´s goals were to assess sociodemographic and clinical differences between patients with and without LC, estimate their mortality rates, and evaluate the independent impact of LC on mortality. Study design and setting This was an observational, longitudinal, and ambispective study of patients with cf-IIP, included from January 1, 2001, and followed until December 31, 2020. All patients were recruited from the ILD Multidisciplinary Unit database of the “XXX”. The “XXX” Society of Pulmonology and Thoracic Surgery (“XXX”) accredited this unit as a high-complexity multidisciplinary unit in the excellent category. The inclusion criteria were age > 18 years, a diagnosis of cf-IIP (IPF, fNSIP), and CPFE. This diagnosis was performed in a multidisciplinary manner based on clinical, radiological and histological criteria (if biopsy data were available), according to the national and international guidelines in force at that time. The exclusion criteria were patients with other fibrotic ILDs and those without follow-up data over time. Ethics The study was conducted in accordance with the Declaration of Helsinki, and the principles of Good Clinical Practice. Approval from the “XXX” Ethics Review Board was obtained (C.I. “XXX”). Data Sources Data were obtained from patients’ clinical histories, which are used in all outpatient interactions between health professionals and patients. Data regarding death were recorded from the “National Death Index”, a national registry based on the Ministry of Health, Consumption, and Social Welfare. Variables The primary outcome of the study was all-cause mortality. The independent variable was LC occurrence during the study period. The anatomopathological classification and staging of LC were based on the 2015 World Health Organization categorization and the TNM 8 th edition, respectively [ 18 , 19 ]. The following covariates were considered: 1) demographic (age and sex); 2) baseline comorbidities (Charlson index, arterial hypertension, dyslipidaemia, obstructive sleep apnoea, pulmonary hypertension, and atrial fibrillation); 3) tobacco and occupational exposure; 4) disease-related variables (date of cf-IIP diagnosis); 5) lung function test; 6) radiological pattern; 7) treatment-related variables; and 8) calendar time dividing the start time of cf-IIP diagnosis into 5-year intervals (from 1 st Jan 2001 until 31 st Dec 2005; 1 st Jan 2006 until 31 st Dec 2010, 1 st Jan 2011 until 31 st Dec 2015, 1 st Jan 2016 until 31 st Dec 2020). Statistical analysis Descriptive analyses of the sociodemographics, comorbidities, clinical and functional lung test results, and treatment characteristics of all included patients were performed. All analyses were carried out with frequency distributions for qualitative variables and means and standard deviations (SDs) or medians and percentiles for quantitative variables. For the study of bivariate associations, the Student´s t-test was used for the analysis of continuous variables with a normal distribution. Continuous variables with nonnormal distribution were analysed via the Mann−Whitney U test or the Kruskal−Wallis test if there were more than two categories. The categorical variables were analysed via the chi-square or Fisher´s exact test. The estimation of mortality was conducted by taking into account all cases of patients diagnosed with cf-IIP and, for each of those cases, observing the time period from the baseline visit (cf-IIP diagnosis) until the occurrence of any of the following cut-off points: main outcome or the end of the study. Kaplan-Meier curves were generated to account for survival over time. The mortality rate (MR) was estimated via survival techniques and expressed as the MR per 1000 patient-years with their respective 95% confidence intervals (CIs). Cox bivariate analyses were performed to assess differences in demographic and clinical covariates and the risk of mortality. Cox multivariate regression analyses were performed to assess the effect of LC on mortality. Other covariates were also evaluated: age, sex, calendar time, other known related factors, and all variables with p < 0.2 in the bivariate analysis. Importantly, the mode in which drug prescription was performed under real-life conditions hampered the categorization of therapeutic options, including antifibrotics, immunosuppressants, and glucocorticoids, which were analysed in a time-dependent manner. During each period, a patient who was receiving any therapy for more than 6 months was exposed. LC and lung function tests were also performed in a time-dependent manner. The results of the regression models are expressed as hazard ratios (HRs) and 95% CIs. The proportional hazard assumption was tested using the Schönfeld residuals and the scaled Schönfeld residuals. All the statistical analyses were performed via STATA software (version 13). A two-tailed p value < 0.05 was considered statistically significant. RESULTS The study included 313 patients with cf-IIP, of whom 245 were male. Overall, 48 (15.3%) patients developed LC. Table 1 summarises the differences between patients with cf-IIP with and without LC. The incidence rates of all‑cause mortality according to different variables in patients with cf-IIP are presented in Table 2. The Kaplan−Meier survival curves are shown in Figure 1. The results of the bivariate and multivariate analyses are detailed in Tables 3 and 4. In another multivariate analysis, LC was identified as an independent risk factor for mortality in patients with cf-IIP (HR: 4.11; 95% CI: 2.50-6.77; p = 0.000). The characteristics of the LCs are presented in Figure 2. In 17 (35.4%) patients, the diagnoses of cf-IIP and LC were simultaneous. For the remaining 31 (64.6%) patients, the mean time from radiological diagnosis of cf-IIP to LC was 38.9 ± 37.4 months. A molecular study was conducted on 18 (37.4%) patients, but no mutations in the epidermal growth factor receptor (EGFR), translocations in the anaplastic lymphoma kinase (ALK) gene, or rearrangements of ROS1 were identified. PD-L1 ( programmed death ligand 1 ) expression was analysed in 23 (47.9%) patients, with 7 (14.6%) showing >50% positive tumour cells. At diagnosis, 68.7% of LC cases were in stages III and IV. The LC treatment is detailed in Table 5. Among the 48 patients analysed, 26 patients (54.2%) presented to the tumor board. DISCUSSION The strengths of this study are the large number of patients with cf-IIP, although these diseases are considered rare, and the extended time that our study comprises, which allowed us to estimate the MR of these patients: 131.5/1000 patient-years (95% CI: 114.8-150.6). It is difficult to compare this result with other series because the MR is rarely calculated, either because of a lack of consensus when classifying these diseases or because of the lack of sufficient observation time required for these studies. Recently, Gonnelli et al. [ 20 ] published in 2024 the mortality trends in IPF across 24 European countries between 2013 and 2018. The overall age- and sex-standardized MR during this period was 3.90 (95% CI: 3.80-3.90) per 100,000 person-years, with substantial intercountry differences. The results of the descriptive analysis of the overall population with cf-IIP were similar to those published in the literature review. Most of the patients were male, of advanced age, current or former smokers with a high pack-year index [ 21 , 22 ], and the most common radiological pattern was usual interstitial pneumonia (UIP) [1]. Our comorbidity profile and spirometric values were consistent with other series, such as the Empire registry performed in 11 countries [ 23 ] and the IPF-PRO registry [ 24 ] (Table 6). The wide dispersion of the data in the lung function test should be emphasized. The mean survival in our cohort was 5.58 ± 0.28 years (95% CI: 4.88-6.09), agreed with other studies [ 25 ]. In our study, the prevalence of LC in patients with cf-IIP was 15.3%, higher than Brown´s study [6] (11.63%), similar to Girard et al. [ 26 ] (14.6%), but lower than the series of necropsies by Matsushita et al. [ 27 ], in which the prevalence of LC in patients with UIP was 48%. The most common histopathological type in the analysed series was squamous cell carcinoma (39.6%), similar to the findings of Jafarinezhad et al. [ 28 ] in UIPs (37.82%) and Girard et al. [26] in CPFEs (36%). In terms of location, >50% of the cases were found in the upper lobes, and the majority were located in the peripheral zone (72.9%), as observed in other reference series [28, 29 , 30 ]. With respect to staging, most of the patients (68.7%) were diagnosed at advanced stages (III-IV), as in the reviewed series [28, 31 , 32 ]. In line with data from other studies, the most commonly utilised treatment was chemotherapy in combination with other methods, even in patients with localized tumours [26, 33 , 34 ]. On the other hand, half of the patients (54.2%) presented to the tumor board. The discussion of cases in a multidisciplinary committee is considered a standard quality criterion in clinical practice [ 35 ]. Importantly, the diagnoses of cf-IIP and LC were simultaneous in 35.4% of patients. These data are similar to those of the series by Tomassetti et al. [ 36 ] (30%) but lower than that reported by Girard [26](57%). Among the remaining patients (64.6%), the mean time from radiological diagnosis of cf-IIP to LC was 38.9 ± 37.4 months (range 1.1-16.8 years). The Girard study [26] reported that the median time interval for the appearance of LC in patients with CPFE was 2.1 years (range 0.6-11.2 years), whereas Yoo et al. [ 37 ] was 38 months (interquartile range: 20-67) in IPF patients. Three key differences emerged between cf-IIP patients with and without LC. First, CPFE was the most frequent radiological pattern in the LC group ( p = 0.000), aligning with the findings of Kato [31] and Portillo [33]. Second, the higher mortality risk in patients with LC (HR: 4.11; 95% CI: 2.50-6.77; p = 0.000) was consistent with the results of the study by Mohamed [34] on IPF (HR: 5.43; 95% CI: 2.19-13.50; p = 0.000) and the study by Lee et al. [ 38 ] on CPFE (HR: 4.05; 95% CI: 2.83-5.80; p < 0.001). Third, treatment disparities were evident. Patients with LC received less treatment ( p = 0.031), although there were no statistically significant differences in antifibrotic treatment ( p = 0.165). These patients may have been undertreated owing to the risk of AE-IPF, as described in the Japanese series [12]. In recent years, the use of antifibrotics has been studied to prevent AE-IPF before and during LC treatment [ 39 ]. Finally, we cannot forget that the only factor that decreased the risk of mortality in cf-IIP patients in our cohort was treatment with antifibrotics (HR: 0.60; 95% CI: 0.43-0.84; p = 0.003), as demonstrated in previous meta-analyses of pirfenidone and nintedanib [ 40 , 41 ]. The limitations of our study were its retrospective design and single-centre setting. CONCLUSIONS The prevalence of LC in patients with cf-IIP is high. Although more studies are needed to further support these findings, we recommend annual chest computed tomography for LC screening in patients with cf-IIP. Antifibrotic treatment should also be prioritised to reduce the mortality rate in these patients and to mitigate AE-IPF risk secondary to LC treatment in the event that they develop it. Abbreviations - AE: acute exacerbation. - AF: atrial fibrillation. - ALK: anaplastic lymphoma kinase . - BMI: body mass index. - CA: cerebrovascular accident. - cf-IIP: chronic fibrosing idiopathic interstitial pneumonia. - CI: confidence interval. - COPD: chronic obstructive pulmonary disease. - CPFE: combined pulmonary fibrosis and emphysema. - CTD: connective tissue disease. - DLCO: diffusing capacity for carbon monoxide. - DM: diabetes mellitus . - EGFR: epidermal growth factor receptor . - fNSIP: fibrotic nonspecific interstitial pneumonia. - FEV1: forced expiratory volume in one second. - FVC: forced vital capacity. - HR: hazard ratio. - IHD: ischaemic heart disease. - IIP: idiopathic interstitial pneumonia. - ILD: interstitial lung disease. - IPF: idiopathic pulmonary fibrosis. - LC: lung cancer. - MR: mortality rate. - 6MWT: 6-min walking test. - NSCC-NOS: non-small-cell carcinoma not otherwise specified. - OAS: obstructive sleep apnea. - p: statistical significance. - PD-L1: programmed death ligand 1 . - PET-CT: positron emission tomography/computed tomography. - PH: pulmonary hypertension. - PVD: peripheral vascular disease. - ROS-1: ROS-1 oncogene rearrangement. - SD: standard deviation. - SpO2: percutaneous oxygen saturation. - SUV max : standardized uptake value. - UIP: usual interstitial pneumonia. Declarations Ethics approval Approval from the Hospital Clínico San Carlos Ethics Review Board was obtained (C.I. 20/607-E). Consent for publication “Not applicable”. Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding This study has not received any funding from public or private sector agencies, nor from any NGOs. Authors' contributions o BMC designed the study, carried it out, interpreted the results and wrote the manuscript. o LAA collaborated in the design of the study and performed the statistical analysis. o JLASW provided advice and correction of the manuscript. o MANB collaborated in the design of the study, provided advice and correction of the manuscript. All authors read and approved the final manuscript. Acknowledgements “Not applicable”. 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Tomassetti S, Gurioli C, Ryu JH, Decker PA, Ravaglia C, Tantalocco P, et alThe impact of lung cancer on survival of idiopathic pulmonary fibrosisChest2015;147(1):157-64https://doi:10.1378/chest.14-0359 Yoo H, Jeong BH, Chung MJ, Lee KS, Kwon OJ, Chung MPRisk factors and clinical characteristics of lung cancer in idiopathic pulmonary fibrosis: a retrospective cohort studyPulm Med2019;19(1):149https://doi:10.1186/s12890-019-0905-8 Lee CH, Kim HJ, Park CM, Lim KY, Lee JY, Kim DJ, et alThe impact of combined pulmonary fibrosis and emphysema on mortalityInt J Tuberc Lung Dis2011;15(8):1111-16https://doi:10.5588/ijtld.10.0491 Iwata T, Yoshino I, Yoshida S, Ikeda N, Tsuboi M, Asato Y, et alA phase II trial evaluating the efficacy and safety of perioperative pirfenidone for prevention of acute exacerbation of idiopathic pulmonary fibrosis in lung cancer patients undergoing pulmonary resection: West Japan Oncology Group 6711 L (PEOPLE Study)Respir Res2016;17(1):90https://doi:10.1186/s12931-016-0398-4 Nathan SD, Albera C, Bradford WZ, Costabel U, Glaspole I, Glassberg MK, et alEffect of pirfenidone on mortality: pooled analyses and meta-analyses of clinical trials in idiopathic pulmonary fibrosisLancet Respir Med2017;5:33-41https://doi:10.1016/S2213-2600(16)30326-5 Finnerty JP, Ponnuswamy A, Dutta P, Abdelaziz A, Kamil HEfficacy of antifibrotic drugs, nintedanib and pirfenidone, in treatment of progressive pulmonary fibrosis in both idiopathic pulmonary fibrosis (IPF) and non-IPF: a systematic review and meta-analysisBMC Pulm Med2021;21(1):411https://doi:10.1186/s12890-021-01783-1 Tables Table 1. Outcomes of all variables studied in patients with cf-IIP expressed globally and stratified by the independent variable (lung cancer). Variable (n) Categories Overall (313) Without LC (265) With LC (48) p a Sex (313) Female Male 68 (21.7) 245 (78.3) 63 (23.8) 202 (76.2) 5 (10.4) 43 (89.6) 0.038 Age (313) Mean ± SD 73.7 ± 7.6 73.9 ± 7.5 72.4 ± 7.7 0.102 75 years 36 (11.5) 51 (16.3) 80 (25.6) 146 (46.6) 28 (10.6) 43 (16.2) 68 (25.7) 126 (47.5) 8 (16.7) 8 (16.7) 12 (25.0) 20 (41.6) 0.653 BMI (313) Mean ± SD 28.0 ± 3.8 27.9 ± 3.8 28.4 ± 3.6 0.468 <24.9 kg 25-29.9 kg 30-34.9 kg ≥35 kg 57 (18.2) 165 (52.7) 76 (24.3) 15 (4.8) 50 (18.9) 140 (52.8) 62 (23.4) 13 (4.9) 7 (14.5) 25 (52.1) 14 (29.2) 2 (4.2) 0.807 Smoking status (313) Never Current smokers Former smokers 88 (28.1) 24 (7.7) 201 (64.2) 87 (32.8) 13 (4.9) 165 (62.3) 1 (2.1) 11 (22.9) 36 (75.0) 0.000 Pack-year index (225) Mean ± SD 43.4 ± 23.0 39.8 ± 22.0 57.0 ± 21.4 1.000 30 11 (3.5) 47 (15.0) 167 (53.4) 10 (5.6) 59 (33.2) 109 (61.2) 1 (2.1) 4 (8.5) 42 (89.4) 0.001 Occupational exposure (278) No contact Inorganic Organic Mixed 119 (42.8) 71 (25.5) 56 (20.2) 32 (11.5) 97 (40.9) 56 (23.6) 53 (22.4) 31 (13.1) 22 (53.7) 15 (36.6) 3 (7.3) 1 (2.4) 0.008 Radiological pattern (313) CPFE UIP fNSIP 100 (32.0) 186 (59.4) 27 (8.6) 67 (25.3) 177 (66.8) 21 (7.9) 33 (68.7) 9 (18.7) 6 (12.6) 0.000 Comorbidity (313) Prevalence Hypertension Dyslipidemia OSA AF IHD Heart failure PVD CA Dementia COPD CTD Ulcer Liver disease DM Hemiparesis Kidney disease Neoplasms 281 (89.8) 180 (57.5) 162 (51.8) 36 (11.5) 43 (13.7) 64 (20.5) 17 (5.4) 22 (7.0) 17 (5.4) 7 (2.2) 33 (10.5) 16 (5.1) 34 (10.9) 6 (1.9) 73 (23.3) 1 (0.3) 4 (1.3) 77 (24.6) 236 (89.1) 154 (58.1) 142 (53.6) 31 (11.7) 38 (14.3) 56 (21.1) 17 (6.4) 19 (7.2) 14 (5.3) 6 (2.3) 23 (8.7) 11 (4.2) 27 (10.2) 2 (0.8) 59 (22.3) 1 (0.4) 2 (0.8) 51 (19.3) 45 (93.8) 26 (54.1) 20 (41.7) 5 (10.4) 5 (10.4) 8 (16.7) 0 (0.0) 3 (6.3) 3 (6.3) 1 (2.1) 10 (20.8) 5 (10.4) 7 (14.6) 4 (8.3) 14 (29.2) 0 (0.0) 2 (4.2) 26 (54.2) 0.441 0.611 0.128 1.000 0.649 0.480 0.085 1.000 0.732 1.000 0.012 0.080 0.368 0.006 0.298 1.000 0.113 0.000 PH (241) No Mild Moderate-severe 127 (52.7) 75 (31.1) 39 (16.2) 100 (49.0) 68 (33.3) 36 (17.7) 27 (73.0) 7 (18.9) 3 (8.1) 0.033 Spirometry (313) FEV1/FVC FEV1 ml FEV1% FVC ml FVC% 79.7 ± 10.4 2084 ± 647.2 91.9 ± 22.2 2656 ± 871.9 89.4 ± 20.8 81.2 ± 9.7 2002.6 ± 650.1 92.5 ± 22.9 2560.1 ± 867.1 88.3 ± 21.2 71.4 ± 9.9 2267.6 ± 522.2 88.9 ± 18.0 3188.8 ± 694.0 95.2 ± 17.3 0.000 0.024 0.302 0.000 0.026 Diffusion (286) DLCO% 57.9 ± 22.0 58.4 ± 22.8 55.6 ± 16.8 0.451 ↓FVC>10% (278) ↓FVC>10% 66 (23.7) 59 (24.2) 7 (20.6) 0.645 ↓DLCO>15% (249) ↓DLCO>15% 67 (26.9) 60 (27.9) 7 (22.6) 0.533 6MWT (171) Distance Initial SpO2 Final SpO2 405.2 ± 125.6 93.4 ± 3.3 83.9 ± 8.0 397.5 ± 125.7 93.2 ± 3.5 83.5 ± 8.1 474.9 ± 102.8 94.4 ± 1.4 86.9 ± 6.1 0.015 0.915 0.947 Treatment Prevalence 184 (58.8) 164 (61.9) 20 (41.7) 0.031 Immunosuppressants 37 (11.8) 34 (12.8) 3 (6.3) 0.233 N-acetylcysteine 95 (30.4) 86 (32.5) 9 (18.8) 0.057 Corticosteroids b 78 (24.9) 71 (26.8) 7 (14.6) 0.072 C. Low doses C. Medium doses C. High doses 25 (8.0) 27 (8.6) 26 (8.3) 22 (8.3) 25 (9.4) 24 (9.1) 3 (6.3) 2 (4.2) 2 (4.2) 0.422 Antifibrotic 77 (24.6) 69 (26.0) 8 (16.7) 0.165 Oxygen 167 (53.4) 150 (56.6) 17 (35.4) 0.007 Mortality (313) Exitus 209 (66.8) 173 (65.3) 36 (75.0) 0.189 a p : Statistically significant results are bolded. b Corticosteroids: low doses 30 mg/day. Abbreviations: cf-IIP, chronic fibrosing idiopathic interstitial pneumonia; LC, lung cancer; p , statistical significance; SD, standard deviation; BMI, body mass index; CPFE, combined pulmonary fibrosis and emphysema; UIP, usual interstitial pneumonia; fNSIP, fibrotic nonspecific interstitial pneumonia; OAS, obstructive sleep apnoea; AF, atrial fibrillation; IHD, ischaemic heart disease; PVD, peripheral vascular disease; CA, cerebrovascular accident; COPD, chronic obstructive pulmonary disease; CTD, connective tissue disease; DM, diabetes mellitus ; PH, pulmonary hypertension; FEV1, forced expiratory volume in one second; FVC, forced vital capacity; DLCO, diffusing capacity for carbon monoxide; 6MWT, 6-min walking test; SpO2, percutaneous oxygen saturation. Table 2. Incidence rate of all‑cause mortality according to different variables in patients with cf-IIP. Variable Patient-year Exitus Rate 95% CI Total series 1589.6 209 131.5 114.8-150.6 Female 381.0 53 139.1 106.3-182.1 Male 1208.6 156 129.1 110.3-151.0 Age 75 years 596.2 106 177.8 147.0-215.1 Never smoker 474.1 69 145.5 114.9-184.3 Current smoker 127.7 13 101.8 59.1-175.3 Former smoker 987.7 127 128.6 108.1-153.0 BMI < 24.9 kg/m 2 275.8 43 155.9 115.6-210.2 BMI: 25-29.9 kg/m 2 821.3 104 126.6 104.5-153.5 BMI: 30-34.9 kg/m 2 420.0 55 130.9 100.5-170.6 BMI ≥ 35 kg/m 2 72.5 7 96.6 46.1-202.7 CPFE 494.3 73 147.7 117.4-185.8 UIP 902.8 118 130.7 109.1-156.6 fNSIP 192.5 18 93.5 58.9-148.4 With comorbidity 1448.4 184 127.0 110.0-146.8 Mild PH 380.9 53 139.2 106.3-182.2 Moderate/severe PH 181.1 37 204.3 148.0-282.0 Not PH 697.4 74 106.1 84.5-133.3 Not COPD 1432.7 187 130.5 113.1-150.6 COPD 156.9 22 140.2 92.3-212.9 Without neoplasms 1215.5 160 131.6 112.7-153.7 Neoplasms 374.1 49 131.0 99.0-173.3 Without LC 1514.4 173 114.2 98.4-132.6 LC 75.2 36 478.9 345.4-663.9 FVC baseline>80% 1148.7 125 108.8 91.3-129.7 FVC baseline60% 882.9 88 99.7 80.9-122.8 DLCO baseline 10% FVC per year 312.9 57 182.2 140.5-236.2 ↓≤ 15% DLCO per year 756.6 59 78.0 60.4-100.7 ↓> 15% DLCO per year 753.7 128 169.8 142.8-201.9 6MWT > 250 m 1508.9 187 123.9 107.4-143.0 6MWT < 250 m 80.7 22 272.6 179.5-414.1 Without treatment 556.3 68 122.2 96.4-155.0 Immunosuppressants 194.2 31 159.6 112.3-227.0 Corticosteroids 402.1 67 166.6 131.1-211.7 N-acetylcysteine 560.9 81 144.4 116.1-179.5 Preantifibrotic combination 584.6 97 165.9 136.0-202.4 Antifibrotics 271.0 29 107.0 74.4-154.0 Combination + antifibrotic 177.7 15 84.4 50.9-140.0 Oxygen 825.5 149 180.5 153.7-211.9 Abbreviations: CI, confidence interval; BMI, body mass index; CPFE, combined pulmonary fibrosis and emphysema; UIP, usual interstitial pneumonia; fNSIP, fibrotic nonspecific interstitial pneumonia; PH, pulmonary hypertension; COPD, chronic obstructive pulmonary disease; LC, lung cancer; FVC, forced vital capacity; DLCO, diffusing capacity for carbon monoxide; 6MWT, 6-min walking test. Table 3. Univariate analysis for mortality. Variable n: 344 a Categories HR 95% CI p b Sex Female Male 1 0.97 - 0.71-1.32 - 0.853 Age < 65 years 65-69.9 years 70-74.9 years ≥75 years 1 1.36 1.38 2.62 - 0.87-2.35 0.85-2.24 1.67-4.12 - 0.271 0.195 0.000 BMI < 24.9 kg/m 2 25-29.9 kg/m 2 30-34.9 kg/m 2 ≥ 35 kg/m 2 1 0.79 0.80 0.63 - 0.56-1.11 0.55-1.17 0.32-1.26 - 0.178 0.251 0.191 Smoking status Never smoker Current smoker Former smoker 1 0.65 0.94 - 0.35-1.21 0.70-1.26 - 0.175 0.672 Occupational exposure No contact Inorganic Organic Mixed 1 1.25 0.90 0.72 - 0.87-1.80 0.60-1.35 0.48-1.08 - 0.226 0.619 0.111 Radiological pattern UIP CPFE fNSIP 1 1.10 0.62 - 0.82-1.48 0.39-1.00 - 0.518 0.052 Comorbidity No Present 1 0.67 - 0.44-1.02 - 0.064 COPD No Present 1 1.05 - 0.66-1.68 - 0.838 PH No Mild Moderate/severe 1 1.38 1.94 - 0.99-1.92 1.25-3.01 - 0.055 0.003 Neoplasms No Present 1 1.01 - 0.72-1.42 - 0.954 LC during the study period No Present 1 4.00 - 2.67-6.01 - 0.000 LC staging No Stage I-II Stage III Stage IV 1 1.78 4.47 8.83 - 0.86-3.71 2.30-8.68 4.41-17.66 - 0.122 0.000 0.000 FEV1/FVC ≥70 <70 1 1.07 - 0.69-1.67 - 0.755 FEV1% ≥80 <80 1 1.01 - 1.01-1.02 - 0.000 FVC% ≥80 <80 1 1.92 - 1.41-2.63 - 0.000 DLCO% c ≥60% <60% 1 2.00 - 1.52-2.70 - 0.000 Distance travelled (6MWT) ≥250 m <250 m 1 2.50 - 1.64-3.85 - 0.000 Treatment No Prefibrotic Antifibrotic Mixed 1 1.33 0.91 0.63 - 0.96-1.85 0.58-1.42 0.38-1.05 - 0.087 0.669 0.079 Immunosuppressants No Yes 1 1.20 - 0.80-1.81 - 0.380 N-acetylcysteine No Yes 1 1.10 - 0.84-14.4 - 0.491 Corticosteroids No Yes 1 1.40 - 1.05-1.84 - 0.021 Antifibrotic No Si 1 0.67 - 0.48-0.92 - 0.013 Oxygen No Yes 1 2.33 - 1.72-3.17 - 0.000 a To take into account the longitudinal study: 313 patients plus the 31 determinations of patients with cf-IIP who develop LC nonsimultaneously. b Statistically significant results are bolded. c There were only 321 measurements, so longitudinal DLCO was not considered. Abbreviations: HR, hazard ratio; CI, confidence interval; p , statistical significance; BMI, body mass index; UIP, usual interstitial pneumonia; CPFE, combined pulmonary fibrosis and emphysema; fNSIP, fibrotic nonspecific interstitial pneumonia; COPD, chronic obstructive pulmonary disease; PH, pulmonary hypertension; LC, lung cancer; FEV1, forced expiratory volume in one second; FVC, forced vital capacity; DLCO, diffusing capacity for carbon monoxide; 6MWT, 6-min walking test. Table 4. Multivariate Cox regression analysis in the research population. Variable Categories HR 95% CI p a Sex Male 0.91 0.60-1.36 0.639 Age ≥75 years 1.02 1.00-1.04 0.023 Smoking status Current smoker Former smoker 0.80 0.88 0.41-1.56 0.60-1.31 0.512 0.539 Radiological pattern CPFE fNSIP 1.04 0.66 0.73-1.47 0.43-1.02 0.831 0.061 LC staging Stage I-II Stage III Stage IV 1.77 4.32 10.30 0.84-3.73 2.03-9.18 3.86-27.49 0.132 0.000 0.000 Distance 6MWT < 250 m 2.33 1.47-3.70 0.000 FVC% < 80 1.96 1.39-2.70 0.000 DLCO% ≥ 60 < 60 0.76 1.71 0.53-1.08 0.90-3.27 0.125 0.103 Treatment Antifibrotic Oxygen 0.60 1.97 0.43-0.84 1.33-2.92 0.003 0.001 a Statistically significant results are bolded. Abbreviations: HR, hazard ratio; CI, confidence interval; p , statistical significance; CPFE, combined pulmonary fibrosis and emphysema; fNSIP, fibrotic nonspecific interstitial pneumonia; LC, lung cancer; 6MWT, 6-min walking test; FVC, forced vital capacity; DLCO, diffusing capacity for carbon monoxide. Table 5 . Treatments regimens for patients with lung cancer and cf-IIP included in the study. Treatment n: 48 (100) I-II Stage n: 15 III Stage n: 18 IV Stage n: 15 Surgery and combinations, n: 13 (27.1) 9 (60.0) 4 (22.2) 0 (0) Chemotherapy and combinations, n: 21 (43.7) 0 (0) 9 (50.0) 12 (80.0) Radiotherapy ± immunotherapy, n: 6 (12.5) 4 (26.7) 2 (11.1) 0 (0) Palliative care, n: 8 (16.7) 2 (13.3) 3 (16.7) 3 (20.0) Data are expressed as n (%). Table 6. Lung function results. Comparison with the studies of Kato (2018) 32 and Yoo (2019) 38 . “XXX” Kato et al. Variable cf-IIP without LC n: 265 cf-IIP with LC n: 48 p a IPF without LC n: 562 IPF with LC n: 70 p a Spirometry FEV1/FVC FEV1% FVC% 265 (100) 81.2 ± 9.7 92.5 ± 22.9 88.3 ± 21.2 48 (100) 71.4 ± 9.9 88.9 ± 18.0 95.2 ± 17.3 0.000 0.302 0.026 562 (100) 80.9 ± 10.7 ---- 75.1 ± 20.1 70 (100) 74.1 ± 9.4 ---- 89.2 ± 16.9 < 0.001 --- < 0.001 Diffusion DLCO% 243 (91.7) 58.4 ± 22.8 43 (89.6) 55.6 ± 16.8 0.451 562 (100) 76.6 ± 23.2 70 (100) 74.9 ± 26.9 0.517 “XXX” Yoo et al. Variable cf-IIP without LC n: 265 cf-IIP with LC n: 48 p a IPF without LC n: 803 IPF with LC n: 135 p a Spirometry-year ↓FVC>10% 244 (92.1) 59 (24.2) 34 (70.8) 7 (20.6) 0.645 599 (74.6) 130 (21.7) 92 (68.1) 18 (19.6) 0.642 Diffusion-year ↓DLCO>15% 215 (81.1) 60 (27.9) 31 (64.6) 7 (22.6) 0.533 490 (61.0) 120 (24.5) 81 (60.0) 12 (14.8) 0.056 The data are expressed as n (%) and the mean ± standard deviation. a Statistically significant results are bolded. Abbreviations: Cf-IIP, chronic fibrosing idiopathic interstitial pneumonia; LC, lung cancer; IPF, Idiopathic pulmonary fibrosis; p , statistical significance; FEV1, forced expiratory volume in one second; FVC, forced vital capacity; DLCO, diffusing capacity for carbon monoxide. (---): data not evaluated. Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5876050","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":405294418,"identity":"a91686b4-9708-48d6-8ae8-3d00b808a6e2","order_by":0,"name":"Beatriz Morales Chacón","email":"data:image/png;base64,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","orcid":"https://orcid.org/0000-0002-7299-1080","institution":"Hospital Clínico San Carlos, Madrid, Spain","correspondingAuthor":true,"prefix":"","firstName":"Beatriz","middleName":"Morales","lastName":"Chacón","suffix":""},{"id":405294419,"identity":"56f2f18b-bdb7-4e49-b154-d44ca23cfb5d","order_by":1,"name":"Lydia Abásolo Alcázar","email":"","orcid":"","institution":"Hospital Clínico San Carlos, Madrid, Spain","correspondingAuthor":false,"prefix":"","firstName":"Lydia","middleName":"Abásolo","lastName":"Alcázar","suffix":""},{"id":405294420,"identity":"2f699520-1d74-4fee-b4e3-033758229c7d","order_by":2,"name":"José Luis Álvarez-Sala Walther","email":"","orcid":"","institution":"Hospital Clínico San Carlos, Madrid, Spain","correspondingAuthor":false,"prefix":"","firstName":"José","middleName":"Luis Álvarez-Sala","lastName":"Walther","suffix":""},{"id":405294421,"identity":"607c2173-37db-4c82-98fe-fed4f157d8b0","order_by":3,"name":"María Asunción Nieto Barbero","email":"","orcid":"","institution":"Hospital Clínico San Carlos, Madrid, Spain","correspondingAuthor":false,"prefix":"","firstName":"María","middleName":"Asunción Nieto","lastName":"Barbero","suffix":""}],"badges":[],"createdAt":"2025-01-21 21:50:30","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-5876050/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5876050/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":74429177,"identity":"20cdf717-54ae-4ddd-a40f-393c2e411219","added_by":"auto","created_at":"2025-01-22 08:27:06","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":49490,"visible":true,"origin":"","legend":"\u003cp\u003eKaplan−Meier survival curves.\u003c/p\u003e\n\u003cp\u003eA. Kaplan−Meier survival curve for overall patients.\u003c/p\u003e\n\u003cp\u003eB. Kaplan−Meier survival curve depending on the presence or absence of lung cancer.\u003c/p\u003e\n\u003cp\u003eC. Kaplan−Meier survival curve according to the lung cancer staging.\u003c/p\u003e","description":"","filename":"Figure1.KaplanMeiersurvivalcurves.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5876050/v1/afc6717a6ed4cb2f816c08bc.jpg"},{"id":74429178,"identity":"63848af3-000d-4fce-af04-53c25b102c3b","added_by":"auto","created_at":"2025-01-22 08:27:06","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":77677,"visible":true,"origin":"","legend":"\u003cp\u003eCharacteristics of lung cancer.\u003c/p\u003e\n\u003cp\u003eData expressed as %.\u003c/p\u003e\n\u003cp\u003eNSCC-NOS: \u003cem\u003enon-small-cell carcinoma not otherwise specified\u003c/em\u003e.\u003c/p\u003e","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5876050/v1/b5fda033e1f7475d0400876c.jpg"},{"id":74430970,"identity":"ecac0e64-70f4-4ed3-b696-839ad8885c91","added_by":"auto","created_at":"2025-01-22 08:43:06","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1526807,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5876050/v1/4395795e-6d39-4b4f-ab2b-42b496c11e0a.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eMortality rate in chronic fibrosing idiopathic interstitial pneumonia: the role of lung cancer\u003c/p\u003e","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eIdiopathic pulmonary fibrosis (IPF) [\u003csup\u003e1\u003c/sup\u003e] and fibrotic nonspecific interstitial pneumonia (fNSIP) [\u003csup\u003e2\u003c/sup\u003e] are\u0026nbsp;categorized as\u0026nbsp;chronic fibrosing idiopathic interstitial pneumonia (cf-IIP). In this group, we included combined pulmonary fibrosis and emphysema (CPFE), which, although it is considered a type of nonclassifiable idiopathic interstitial pneumonia (IIP), shares a fibrotic character and poor prognosis with previous methods [\u003csup\u003e3\u003c/sup\u003e].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLung cancer (LC) remains the leading cause of cancer-related mortality, with a 5-year overall survival rate of only 20% [\u003csup\u003e4\u003c/sup\u003e]. Since 1953, the association between interstitial lung disease (ILD) and LC has been\u0026nbsp;recognized [\u003csup\u003e5\u003c/sup\u003e]. IPF and LC have\u0026nbsp;common risk and etiological factors,\u0026nbsp;such as male sex, advanced age, and a history of smoking [\u003csup\u003e6\u003c/sup\u003e].\u0026nbsp;Additionally, they share pathogenic mechanisms at the cellular, molecular, genetic, and epigenetic levels [\u003csup\u003e7\u003c/sup\u003e].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe coexistence of both diseases in the same patient raises many doubts regarding prognosis and complicates decision-making in multidisciplinary thoracic committees. We generally undertreat these patients due to the risk of acute exacerbation (AE) [\u003csup\u003e8\u003c/sup\u003e] associated with LC diagnostic and therapeutic procedures, whether with surgery [\u003csup\u003e9\u003c/sup\u003e, \u003csup\u003e10\u003c/sup\u003e], chemotherapy [\u003csup\u003e11\u003c/sup\u003e, \u003csup\u003e12\u003c/sup\u003e, \u003csup\u003e13\u003c/sup\u003e], molecular targets [\u003csup\u003e14\u003c/sup\u003e], immune checkpoint inhibitors [\u003csup\u003e15\u003c/sup\u003e, \u003csup\u003e16\u003c/sup\u003e], or stereotactic radiotherapy [\u003csup\u003e17\u003c/sup\u003e].\u0026nbsp;\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003e\u003cstrong\u003e\u003cu\u003eObjetive\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo provide new perspectives on the management and long-term prognosis of cf-IIP patients in clinical practice, our study´s goals were to assess sociodemographic and clinical differences between patients with and without LC, estimate their mortality rates, and evaluate the independent impact of LC on mortality.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eStudy design and setting\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis was an observational, longitudinal, and ambispective study of patients with cf-IIP, included from January 1, 2001, and followed until December 31, 2020.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll patients were recruited from the ILD Multidisciplinary Unit database of the “XXX”. The “XXX” Society of Pulmonology and Thoracic Surgery (“XXX”) accredited this unit as a high-complexity multidisciplinary unit in the excellent category.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe inclusion criteria were age \u0026gt; 18 years, a diagnosis of cf-IIP (IPF, fNSIP), and CPFE. This diagnosis was performed in a multidisciplinary manner based on clinical, radiological and histological criteria (if biopsy data were available), according to the national and international guidelines in force at that time.\u003c/p\u003e\n\u003cp\u003eThe exclusion criteria were patients with other fibrotic ILDs and those without follow-up data over time.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eEthics\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted in accordance with the Declaration of Helsinki, and the principles of Good Clinical Practice. \u0026nbsp;Approval from the “XXX” Ethics Review Board was obtained (C.I. “XXX”).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eData Sources\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were obtained from patients’ clinical histories, which are used in all outpatient interactions between health professionals and patients. Data regarding death were recorded from the “National Death Index”, a national registry based on the Ministry of Health, Consumption, and Social Welfare.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eVariables\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe primary outcome of the study was all-cause mortality. The independent variable was LC occurrence during the study period. The anatomopathological classification and staging of LC were based on the 2015 World Health Organization categorization and the TNM 8\u003csup\u003eth\u003c/sup\u003e edition, respectively [\u003csup\u003e18\u003c/sup\u003e, \u003csup\u003e19\u003c/sup\u003e].\u003c/p\u003e\n\u003cp\u003eThe following covariates were considered: 1) demographic (age and sex); 2) baseline comorbidities (Charlson index, arterial hypertension, dyslipidaemia, obstructive sleep apnoea, pulmonary hypertension, and atrial fibrillation); 3) tobacco and occupational exposure; 4) disease-related variables (date of cf-IIP diagnosis); 5) lung function test; 6) radiological pattern; 7) treatment-related variables; and 8) calendar time dividing the start time of cf-IIP diagnosis into 5-year intervals (from 1\u003csup\u003est\u003c/sup\u003e Jan 2001 until 31\u003csup\u003est\u003c/sup\u003e Dec 2005; 1\u003csup\u003est\u0026nbsp;\u003c/sup\u003eJan 2006 until 31\u003csup\u003est\u003c/sup\u003e Dec 2010, 1\u003csup\u003est\u003c/sup\u003e Jan 2011 until 31\u003csup\u003est\u003c/sup\u003e Dec 2015, 1\u003csup\u003est\u003c/sup\u003e Jan 2016 until 31\u003csup\u003est\u003c/sup\u003e Dec 2020).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eStatistical analysis\u0026nbsp;\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDescriptive analyses of the sociodemographics, comorbidities, clinical and functional lung test results, and treatment characteristics of all included patients were performed. All analyses were carried out with frequency distributions for qualitative variables and means and standard deviations (SDs) or medians and percentiles for quantitative variables. For the study of bivariate associations, the Student´s t-test was used for the analysis of continuous variables with a normal distribution. Continuous variables with nonnormal distribution were analysed via the Mann−Whitney U test or the Kruskal−Wallis test if there were more than two categories. The categorical variables were analysed via the chi-square or Fisher´s exact test.\u003c/p\u003e\n\u003cp\u003eThe estimation of mortality was conducted by taking into account all cases of patients diagnosed with cf-IIP and, for each of those cases, observing the time period from the baseline visit (cf-IIP diagnosis) until the occurrence of any of the following cut-off points: main outcome or the end of the study. Kaplan-Meier curves were generated to account for survival over time. The mortality rate (MR) was estimated via survival techniques and expressed as the MR per 1000 patient-years with their respective 95% confidence intervals (CIs).\u003c/p\u003e\n\u003cp\u003eCox bivariate analyses were performed to assess differences in demographic and clinical covariates and the risk of mortality. Cox multivariate regression analyses were performed to assess the effect of LC on mortality. Other covariates were also evaluated: age, sex, calendar time, other known related factors, and all variables with p \u0026lt; 0.2 in the bivariate analysis. Importantly, the mode in which drug prescription was performed under real-life conditions hampered the categorization of therapeutic options, including antifibrotics, immunosuppressants, and glucocorticoids, which were analysed in a time-dependent manner. During each period, a patient who was receiving any therapy for more than 6 months was exposed. LC and lung function tests were also performed in a time-dependent manner.\u003c/p\u003e\n\u003cp\u003eThe results of the regression models are expressed as hazard ratios (HRs) and 95% CIs. The proportional hazard assumption was tested using the Schönfeld residuals and the scaled Schönfeld residuals. All the statistical analyses were performed via STATA software (version 13). A two-tailed \u003cem\u003ep\u003c/em\u003e value \u0026lt; 0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003eThe study included 313 patients with cf-IIP, of whom 245 were male. Overall, 48 (15.3%) patients developed LC. Table 1 summarises the differences between patients with cf-IIP with and without LC.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe incidence rates of all‑cause mortality according to different variables in patients with cf-IIP are presented in Table 2. The\u0026nbsp;Kaplan\u0026minus;Meier survival curves are shown in Figure 1. The results of the bivariate and multivariate analyses are detailed in Tables 3 and 4. In another multivariate analysis, LC was identified as an independent risk factor for mortality in patients with cf-IIP (HR: 4.11; 95% CI: 2.50-6.77; \u003cem\u003ep\u003c/em\u003e = 0.000).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe characteristics of the LCs are presented in Figure 2. In 17 (35.4%) patients, the diagnoses of cf-IIP and LC were simultaneous. For the remaining 31 (64.6%) patients, the mean time from radiological diagnosis of cf-IIP to LC was 38.9 \u0026plusmn; 37.4 months. A molecular study was conducted on 18 (37.4%) patients, but no mutations in the \u003cem\u003eepidermal growth factor receptor\u003c/em\u003e (EGFR), translocations in the \u003cem\u003eanaplastic lymphoma kinase\u003c/em\u003e (ALK) gene, or rearrangements of ROS1 were identified. PD-L1 (\u003cem\u003eprogrammed death ligand 1\u003c/em\u003e) expression was analysed in 23 (47.9%) patients, with 7 (14.6%) showing \u0026gt;50% positive tumour cells. At diagnosis, 68.7% of LC cases were in stages III and IV. The LC treatment is detailed in Table 5. Among the 48 patients analysed, 26 patients (54.2%) presented to the tumor board.\u0026nbsp;\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe strengths of this study are the large number of patients with cf-IIP, although these diseases are considered rare, and the extended time that our study comprises, which allowed us to estimate the MR of these patients: 131.5/1000 patient-years (95% CI: 114.8-150.6). It is difficult to compare this result with other series because the MR is rarely calculated, either because of a lack of consensus when classifying these diseases or because of the lack of sufficient observation time required for these studies. Recently,\u0026nbsp;Gonnelli et al. [\u003csup\u003e20\u003c/sup\u003e] published in 2024 the mortality trends in IPF across 24 European countries between 2013 and 2018. The overall age- and sex-standardized MR during this period was 3.90 (95% CI: 3.80-3.90) per 100,000 person-years, with substantial intercountry differences.\u003c/p\u003e\n\u003cp\u003eThe results of the descriptive analysis of the overall population with cf-IIP were similar to those published in the literature review. Most of the patients were male, of advanced age, current or former smokers with a high pack-year index [\u003csup\u003e21\u003c/sup\u003e, \u003csup\u003e22\u003c/sup\u003e], and the most common radiological pattern was usual interstitial pneumonia (UIP) [1]. Our comorbidity profile and spirometric values were consistent with other series, such as the Empire registry performed in 11 countries [\u003csup\u003e23\u003c/sup\u003e] and the IPF-PRO registry [\u003csup\u003e24\u003c/sup\u003e] (Table 6). The wide dispersion of the data in the lung function test should be emphasized. The mean survival in our cohort was 5.58 ± 0.28 years (95% CI: 4.88-6.09), agreed with other studies [\u003csup\u003e25\u003c/sup\u003e].\u003c/p\u003e\n\u003cp\u003eIn our study, the prevalence of LC in patients with cf-IIP was 15.3%, higher than Brown´s study [6] (11.63%), similar to Girard et al. [\u003csup\u003e26\u003c/sup\u003e] (14.6%), but lower than the series of necropsies by Matsushita et al. [\u003csup\u003e27\u003c/sup\u003e], in which the prevalence of LC in patients with UIP was 48%.\u003c/p\u003e\n\u003cp\u003eThe most common histopathological type in the analysed series was squamous cell carcinoma (39.6%), similar to the findings of Jafarinezhad et al. [\u003csup\u003e28\u003c/sup\u003e] in UIPs (37.82%) and Girard et al. [26] in CPFEs (36%). In terms of location, \u0026gt;50% of the cases were found in the upper lobes, and the majority were located in the peripheral zone (72.9%), as observed in other reference series [28, \u003csup\u003e29\u003c/sup\u003e, \u003csup\u003e30\u003c/sup\u003e].\u003c/p\u003e\n\u003cp\u003eWith respect to staging, most of the patients (68.7%) were diagnosed at advanced stages (III-IV), as in the reviewed series [28, \u003csup\u003e31\u003c/sup\u003e, \u003csup\u003e32\u003c/sup\u003e]. In line with data from other studies, the most commonly utilised treatment was chemotherapy in combination with other methods, even in patients with localized tumours [26, \u003csup\u003e33\u003c/sup\u003e, \u003csup\u003e34\u003c/sup\u003e]. On the other hand, half of the patients (54.2%) presented to the tumor board. The discussion of cases in a multidisciplinary committee is considered a standard quality criterion in clinical practice [\u003csup\u003e35\u003c/sup\u003e].\u003c/p\u003e\n\u003cp\u003eImportantly, the diagnoses of cf-IIP and LC were simultaneous in 35.4% of patients. These data are similar to those of the series by Tomassetti et al. [\u003csup\u003e36\u003c/sup\u003e] (30%) but lower than that reported by Girard [26](57%). Among the remaining patients (64.6%), the mean time from radiological diagnosis of cf-IIP to LC was 38.9 ± 37.4 months (range 1.1-16.8 years). The Girard study [26] reported that the median time interval for the appearance of LC in patients with CPFE was 2.1 years (range 0.6-11.2 years), whereas Yoo et al. [\u003csup\u003e37\u003c/sup\u003e] was 38 months (interquartile range: 20-67) in IPF patients.\u003c/p\u003e\n\u003cp\u003eThree key differences emerged between cf-IIP patients with and without LC. First, CPFE was the most frequent radiological pattern in the LC group (\u003cem\u003ep\u003c/em\u003e = 0.000), aligning with the findings of Kato [31] and Portillo [33]. Second, the higher mortality risk in patients with LC (HR: 4.11; 95% CI: 2.50-6.77; \u003cem\u003ep\u003c/em\u003e = 0.000) was consistent with the results of the study by Mohamed [34] on IPF (HR: 5.43; 95% CI: 2.19-13.50;\u003cem\u003e\u0026nbsp;p\u003c/em\u003e = 0.000) and the study by Lee et al. [\u003csup\u003e38\u003c/sup\u003e] on CPFE (HR: 4.05; 95% CI: 2.83-5.80; \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001). Third, treatment disparities were evident. Patients with LC received less treatment (\u003cem\u003ep\u003c/em\u003e = 0.031), although there were no statistically significant differences in antifibrotic treatment (\u003cem\u003ep\u003c/em\u003e = 0.165). These patients may have been undertreated owing to the risk of AE-IPF, as described in the Japanese series [12]. In recent years, the use of antifibrotics has been studied to prevent AE-IPF before and during LC treatment [\u003csup\u003e39\u003c/sup\u003e].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFinally, we cannot forget that the only factor that decreased the risk of mortality in cf-IIP patients in our cohort was treatment with antifibrotics (HR: 0.60; 95% CI: 0.43-0.84; \u003cem\u003ep\u003c/em\u003e = 0.003), as demonstrated in previous meta-analyses of pirfenidone and nintedanib [\u003csup\u003e40\u003c/sup\u003e, \u003csup\u003e41\u003c/sup\u003e].\u003c/p\u003e\n\u003cp\u003eThe limitations of our study were its retrospective design and single-centre setting.\u0026nbsp;\u003c/p\u003e"},{"header":"CONCLUSIONS","content":"\u003cp\u003eThe prevalence of LC in patients with cf-IIP is high. Although more studies are needed to further support these findings, we recommend annual chest computed tomography for LC screening in patients with cf-IIP. Antifibrotic treatment should also be prioritised to reduce the mortality rate in these patients and to mitigate AE-IPF risk secondary to LC treatment in the event that they develop it.\u0026nbsp;\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;AE: acute exacerbation.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;AF: atrial fibrillation.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;ALK: \u003cem\u003eanaplastic lymphoma kinase\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;BMI: body mass index.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;CA: cerebrovascular accident.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;cf-IIP: chronic fibrosing idiopathic interstitial pneumonia.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;CI: confidence interval.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;COPD: chronic obstructive pulmonary disease.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;CPFE: combined pulmonary fibrosis and emphysema.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;CTD: connective tissue disease.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;DLCO: diffusing capacity for carbon monoxide.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;DM: diabetes \u003cem\u003emellitus\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;EGFR: \u003cem\u003eepidermal growth factor receptor\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;fNSIP: fibrotic nonspecific interstitial pneumonia.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;FEV1: forced expiratory volume in one second.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;FVC: forced vital capacity.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;HR: hazard ratio.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;IHD: ischaemic heart disease.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;IIP: idiopathic interstitial pneumonia.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;ILD: interstitial lung disease.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;IPF: idiopathic pulmonary fibrosis.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;LC: lung cancer.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;MR: mortality rate.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;6MWT: 6-min walking test.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;NSCC-NOS: \u003cem\u003enon-small-cell carcinoma not otherwise specified.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;OAS: obstructive sleep apnea.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;p: statistical significance.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;PD-L1: \u003cem\u003eprogrammed death ligand 1\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003e- PET-CT:\u0026nbsp;positron emission tomography/computed tomography.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;PH: pulmonary hypertension.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;PVD: peripheral vascular disease.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;ROS-1: ROS-1 oncogene rearrangement.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;SD: standard deviation.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;SpO2: percutaneous oxygen saturation.\u003c/p\u003e\n\u003cp\u003e- SUV\u003csub\u003emax\u003c/sub\u003e:\u0026nbsp;\u003cem\u003estandardized uptake value.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e- UIP: usual interstitial pneumonia.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eApproval from the Hospital Clínico San Carlos Ethics Review Board was obtained (C.I. 20/607-E).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e“Not applicable”.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study has not received any funding from public or private sector agencies, nor from any NGOs.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eo BMC designed the study, carried it out, interpreted the results and wrote the manuscript.\u003c/p\u003e\n\u003cp\u003eo LAA collaborated in the design of the study and performed the statistical analysis.\u003c/p\u003e\n\u003cp\u003eo JLASW provided advice and correction of the manuscript.\u003c/p\u003e\n\u003cp\u003eo MANB collaborated in the design of the study, provided advice and correction of the manuscript.\u003c/p\u003e\n\u003cp\u003eAll authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e“Not applicable”.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eRaghu G, Collard HR, Egan JJ, Mart\u0026iacute;nez FJ, Behr J, Brown KK, et alAn official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: Evidence-based guidelines for diagnosis and managementAm J Respir Crit Care Med2011;183(6):788-824https://doi:10.1164/rccm.2009-040GL\u003c/li\u003e\n \u003cli\u003eTravis WD, Hunninghake G, King TE, Lynch DA, Colby TV, Galvin JR, et alIdiopathic nonspecific interstitial pneumonia: report of an American Thoracic Society projectAm J Respir Crit Care Med2008;177(12):1338-47https://doi:10.1164/rccm.200611-1685OC\u003c/li\u003e\n \u003cli\u003eCottin V, Nunes H, Brillet PY, Delaval P, Devouassoux G, Tillie-Leblond I, et alCombined pulmonary fibrosis and emphysema: a distinct underrecognized entityEur Respir J2005;26(4):586-93https://doi:10.1183/09031936.05.00021005\u003c/li\u003e\n \u003cli\u003eSung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray FGlobal cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countriesCA Cancer J Clin2021;71(3):209-249. https://doi:10.3322/caac.21660\u003c/li\u003e\n \u003cli\u003eZatuchni J, Campbell WN, Zarafonetis CJPulmonary fibrosis and terminal bronchiolar (alveolar-cell) carcinoma in sclerodermaCancer1953;6(6):1147-58https://doi:10.1002/1097-0142(195311)6:6\u0026lt;1147::aid-cncr2820060605\u0026gt;3.0.co;2-l\u003c/li\u003e\n \u003cli\u003eBrown SW, Dobelle M, Padilla M, Agovino M, Wisnivesky JP, Hashim D, et alIdiopathic pulmonary fibrosis and lung cancer: a systematic review and meta-analysisAnn Am Thorac Soc2019;16(8):1041-51https://doi:10.1513/AnnalsATS.201807-481OC\u003c/li\u003e\n \u003cli\u003eBallester B, Milara J, Cortijo JIdiopathic pulmonary fibrosis and lung cancer: mechanisms and molecular targetsInt J Mol Sci2019;20(3):593. https://doi:10.3390/ijms20030593\u003c/li\u003e\n \u003cli\u003eCollard HR, Ryerson CJ, Corte TJ, Jenkins G, Kondoh Y, Lederer DJ, et alAcute exacerbation of idiopathic pulmonary fibrosisAn international working group reportAm J Respir Crit Care Med2016;194(3):265-75https://doi:10.1164/rccm.201604-0801CI\u003c/li\u003e\n \u003cli\u003eSato T, Teramukai S, Kondo H, Watanabe A, Ebina M, Kishi K, et alImpact and predictors of acute exacerbation of interstitial lung diseases after pulmonary resection for lung cancerJ Thorac Cardiovasc Surg2014;147(5):1604-11https://doi:10.1016/j.jtcvs.2013.09.050\u003c/li\u003e\n \u003cli\u003eGoto TMeasuring surgery outcomes of lung cancer patients with concomitant pulmonary fibrosis: a review of the literatureCancers2018;10(7):223https://doi:10.3390/cancers10070223\u003c/li\u003e\n \u003cli\u003eWatanabe N, Niho S, Kirita K, Umemura S, Matsumoto S, Yoh K, et alVinorelbine and cisplatin in patients with advanced non‐small cell lung cancer with interstitial pneumoniaAnticancer Res2015;35(3):1697-701\u003c/li\u003e\n \u003cli\u003eEnomoto Y, Kenmotsu H, Watanabe N, Baba T, Murakami H, Yoh K, et alEfficacy and safety of combined carboplatin, paclitaxel, and bevacizumab for patients with advanced non‐squamous non‐small cell lung cancer with pre‐existing interstitial lung disease: a retrospective multi‐institutional studyAnticancer Res2015;35(7):4259-63\u003c/li\u003e\n \u003cli\u003eKenmotsu H, Naito T, Mori K, Ko R, Ono A, Wakuda K, et alEffect of platinum‐based chemotherapy for non‐small cell lung cancer patients with interstitial lung diseaseCancer Chemother Pharmacol2015;75(3):521-26https://doi:10.1007/s00280-014-2670-y\u003c/li\u003e\n \u003cli\u003eAndo M, Okamoto I, Yamamoto N, Takeda K, Tamura K, Seto T, et alPredictive factors for interstitial lung disease, antitumour response, and survival in non-small cell lung cancer patients treated with gefitinibJ Clin Oncol2006:24(16):2549-56https://doi:10.1200/JCO.2005.04.9866\u003c/li\u003e\n \u003cli\u003eNishino M, Giobbie-Hurder A, Hatabu H, Ramaiya NH, Hodi FSIncidence of programmed cell death 1 inhibitor-related pneumonitis in patients with advanced cancer: a systematic review and meta-analysisJAMA Oncol2016;2(12):1607-16https://doi:10.1001/jamaoncol.2016.2453\u003c/li\u003e\n \u003cli\u003eNishino M, Ramaiya NH, Awad MM, Sholl LM, Maattala JA, Taibi M, et alPD-1 inhibitor-related pneumonitis in advanced cancer patients: radiographic patterns and clinical courseClin Cancer Res2016;22(24):6051-60https://doi:10.1158/1078-0432.CCR-16-1320\u003c/li\u003e\n \u003cli\u003eTsurugai Y, Takeda A, Sanuki N, Enomoto T, Kaneko T, Hara Y, et alStereotactic body radiotherapy for lung cancer patients with idiopathic interstitial pneumoniaRadiother Oncol2017;125(2):310-16https://doi:10.1016/j.radonc.2017.08.026\u003c/li\u003e\n \u003cli\u003eTravis WD, Brambilla E, Burke AP, Marx A, Nicholson AGWHO Classification of tumours of the lung, pleura, thymus and heartLyon: International Agency for Research on Cancer2015;10(9):1240-42https://doi:10.1097/JTO.0000000000000663\u003c/li\u003e\n \u003cli\u003eGoldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WEE, et alThe IASLC Lung Cancer Staging Project: Proposals for revision of the TNM stage groupings in the forthcoming Eighth Edition of the TNM classification for lung cancerJ Thorac Oncol2016;11(1):39-51https://doi:10.1016/j.jtho.2015.09.009\u003c/li\u003e\n \u003cli\u003eGonnelli F, Bonifazi M, Hubbard RMortality trends in idiopathic pulmonary fibrosis in Europe between 2013 and 2018Eur Respir J2024;64:2302080https://doi:10.1183/13993003.02080-2023\u003c/li\u003e\n \u003cli\u003eRaghu G, Chen SY, Yeh WS, Maroni B, Li Q, Lee YC, Collard HRIdiopathic pulmonary fibrosis in US Medicare beneficiaries aged 65 years and older: incidence, prevalence, and survival, 2001-11Lancet Respir Med2014;2(7):566-72. https://doi:10.1016/S2213-2600(14)70101-8\u003c/li\u003e\n \u003cli\u003eKitaguchi Y, Fujimoto K, Hanaoka M, Kawakami S, Honda T, Kubo KClinical characteristics of combined pulmonary fibrosis and emphysemaRespirology2010;15(2):265-71https://doi:10.1111/j.1440-1843.2009.01676.x\u003c/li\u003e\n \u003cli\u003eJovanovic DM, \u0026Scaron;terclov\u0026aacute; M, Mogulkoc N, Lewandowska K, M\u0026uuml;ller V, H\u0026aacute;jkov\u0026aacute; M, et alComorbidity burden and survival in patients with idiopathic pulmonary fibrosis: the EMPIRE registry studyRespir Res2022;23(1):135https://doi:10.1186/s12931-022-02033-6\u003c/li\u003e\n \u003cli\u003eKim HJ, Snyder LD, Neely ML, Hellkamp AS, Hotchkin DL, MorrisinLD, et alClinical outcomes of patients with combined idiopathic pulmonary fibrosis and emphysema in the IPF-PRO registryLung2022;200(1):21-29https://doi:10.1007/s00408-021-00506-x\u003c/li\u003e\n \u003cli\u003eTravis WD, Costabel U, Hansell DM, King TE, Lynch DA, Nicholson AG, et alAn official American Thoracic Society/European Respiratory Society statement: Update of the International Multidisciplinary Classification of the Idiopathic Interstitial PneumoniasAm J Respir Crit Care Med2013;188(6):733-48https://doi:10.1164/rccm.201308-1483ST\u003c/li\u003e\n \u003cli\u003eGirard N, Marchand-Adam S, Naccache JM, Borie R, Urban T, Jouneau S, et alLung cancer in combined pulmonary fibrosis and emphysemaA series of 47 western patientsJ Thorac Oncol2014;9(8):1162-70https://doi:10.1097/JTO.0000000000000209\u003c/li\u003e\n \u003cli\u003eMatsushita H, Tanaka S, Saiki Y, Hara M, Nakata K, Tanimura S, Banba JLung cancer associated with usual interstitial pneumoniaPathol Int1995;45(12):925-32. https://doi:10.1111/j.1440-1827.1995.tb03417.x\u003c/li\u003e\n \u003cli\u003eJafariNezhad A, YektaKooshali MHLung cancer in idiopathic pulmonary fibrosis: A systematic review and meta-analysisPLoS ONE2018;13(8): e0202360. https://doi:10.1371/journal.pone.0202360\u003c/li\u003e\n \u003cli\u003eKishi K, Homma S, Kurosaki A, Motoi N, Yoshimura KHigh-resolution computed tomography findings of lung cancer associated with idiopathic pulmonary fibrosisJ Comput Assist Tomogr2006;30(1):95-99 https://doi:10.1097/01.rct.0000188650.66527.d2\u003c/li\u003e\n \u003cli\u003ePark J, Kim DS, Shim TS, Lim CM, Koh Y, Lee SD, et alLung cancer in patients with idiopathic pulmonary fibrosisEur Respir J2001;17(6):1216-19. https://doi:10.1183/09031936.01.99055301\u003c/li\u003e\n \u003cli\u003eKato E, Takayanagi N, Takaku Y, Kagiyama N, Kanauchi T, Ishiguro T, Sugita YIncidence and predictive factors of lung cancer in patients with idiopathic pulmonary fibrosisERJ Open Res2018;4(1):00111-2016https://doi:10.1183/23120541.00111-2016\u003c/li\u003e\n \u003cli\u003eFeng X, Duan Y, Lv X, Li Q, Liang B, Ou XThe impact of lung cancer in patients with combined pulmonary fibrosis and emphysema (CPFE)J Clin Med2023;12(3):1100https://doi:10.3390/jcm12031100\u003c/li\u003e\n \u003cli\u003ePortillo K, Perez-Rodas N, Garc\u0026iacute;a-Oliv\u0026eacute; I, Guasch-Arriaga I, Centeno C, Serra P, et alC\u0026aacute;ncer de pulm\u0026oacute;n en pacientes con combinaci\u0026oacute;n de fibrosis pulmonar y enfisema y fibrosis pulmonar idiop\u0026aacute;ticaEstudio descriptivo en una serie espa\u0026ntilde;olaArch Bronconeumol2017;53(6):304-10https://doi:10.1016/j.arbres.2016.10.004\u003c/li\u003e\n \u003cli\u003eMohamed S, Bayoumi H, Abd El-Aziz N, Mousa E, Gamal YPrevalence, risk factors, and impact of lung cancer on outcomes of idiopathic pulmonary fibrosis: a study from the Middle EastMultidis Respir Med2018;13:37https://doi:10.1186/s40248-018-0150-7\u003c/li\u003e\n \u003cli\u003eMontoro FJ, Pav\u0026oacute;n MJ, Hoyos NIndicadores de calidad en c\u0026aacute;ncer de pulm\u0026oacute;nIn: Ram\u0026iacute;rez MT, Peces-Barba G, Ussetti P, Jurestschke MA, Puente L, Pardo A, editorsIndicadores de calidad en enfermedades respiratoriasNeumoMadridMadrid: Editorial Ergon2017;39-52.\u003c/li\u003e\n \u003cli\u003eTomassetti S, Gurioli C, Ryu JH, Decker PA, Ravaglia C, Tantalocco P, et alThe impact of lung cancer on survival of idiopathic pulmonary fibrosisChest2015;147(1):157-64https://doi:10.1378/chest.14-0359\u003c/li\u003e\n \u003cli\u003eYoo H, Jeong BH, Chung MJ, Lee KS, Kwon OJ, Chung MPRisk factors and clinical characteristics of lung cancer in idiopathic pulmonary fibrosis: a retrospective cohort studyPulm Med2019;19(1):149https://doi:10.1186/s12890-019-0905-8\u003c/li\u003e\n \u003cli\u003eLee CH, Kim HJ, Park CM, Lim KY, Lee JY, Kim DJ, et alThe impact of combined pulmonary fibrosis and emphysema on mortalityInt J Tuberc Lung Dis2011;15(8):1111-16https://doi:10.5588/ijtld.10.0491\u003c/li\u003e\n \u003cli\u003eIwata T, Yoshino I, Yoshida S, Ikeda N, Tsuboi M, Asato Y, et alA phase II trial evaluating the efficacy and safety of perioperative pirfenidone for prevention of acute exacerbation of idiopathic pulmonary fibrosis in lung cancer patients undergoing pulmonary resection: West Japan Oncology Group 6711 L (PEOPLE Study)Respir Res2016;17(1):90https://doi:10.1186/s12931-016-0398-4\u003c/li\u003e\n \u003cli\u003eNathan SD, Albera C, Bradford WZ, Costabel U, Glaspole I, Glassberg MK, et alEffect of pirfenidone on mortality: pooled analyses and meta-analyses of clinical trials in idiopathic pulmonary fibrosisLancet Respir Med2017;5:33-41https://doi:10.1016/S2213-2600(16)30326-5\u003c/li\u003e\n \u003cli\u003eFinnerty JP, Ponnuswamy A, Dutta P, Abdelaziz A, Kamil HEfficacy of antifibrotic drugs, nintedanib and pirfenidone, in treatment of progressive pulmonary fibrosis in both idiopathic pulmonary fibrosis (IPF) and non-IPF: a systematic review and meta-analysisBMC Pulm Med2021;21(1):411https://doi:10.1186/s12890-021-01783-1\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1.\u003c/strong\u003e Outcomes of all variables studied in patients with cf-IIP expressed globally and stratified by the independent variable (lung cancer).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall (313)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWithout LC (265)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWith LC (48)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eSex (313)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e68 (21.7)\u003c/p\u003e\n \u003cp\u003e245 (78.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e63 (23.8)\u003c/p\u003e\n \u003cp\u003e202 (76.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e5 (10.4)\u003c/p\u003e\n \u003cp\u003e43 (89.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.038\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eAge (313)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e73.7 \u0026plusmn; 7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e73.9 \u0026plusmn; 7.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e72.4 \u0026plusmn; 7.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e0.102\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026lt;65 years\u003c/p\u003e\n \u003cp\u003e65-70 years\u003c/p\u003e\n \u003cp\u003e70-75 years\u003c/p\u003e\n \u003cp\u003e\u0026gt;75 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e36 (11.5)\u003c/p\u003e\n \u003cp\u003e51 (16.3)\u003c/p\u003e\n \u003cp\u003e80 (25.6)\u003c/p\u003e\n \u003cp\u003e146 (46.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e28 (10.6)\u003c/p\u003e\n \u003cp\u003e43 (16.2)\u003c/p\u003e\n \u003cp\u003e68 (25.7)\u003c/p\u003e\n \u003cp\u003e126 (47.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e8 (16.7)\u003c/p\u003e\n \u003cp\u003e8 (16.7)\u003c/p\u003e\n \u003cp\u003e12 (25.0)\u003c/p\u003e\n \u003cp\u003e20 (41.6)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.653\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eBMI (313)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e28.0 \u0026plusmn; 3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e27.9 \u0026plusmn; 3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e28.4 \u0026plusmn; 3.6\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e0.468\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026lt;24.9 kg\u003c/p\u003e\n \u003cp\u003e25-29.9 kg\u003c/p\u003e\n \u003cp\u003e30-34.9 kg\u003c/p\u003e\n \u003cp\u003e\u0026ge;35 kg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e57 (18.2)\u003c/p\u003e\n \u003cp\u003e165 (52.7)\u003c/p\u003e\n \u003cp\u003e76 (24.3)\u003c/p\u003e\n \u003cp\u003e15 (4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e50 (18.9)\u003c/p\u003e\n \u003cp\u003e140 (52.8)\u003c/p\u003e\n \u003cp\u003e62 (23.4)\u003c/p\u003e\n \u003cp\u003e13 (4.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e7 (14.5)\u003c/p\u003e\n \u003cp\u003e25 (52.1)\u003c/p\u003e\n \u003cp\u003e14 (29.2)\u003c/p\u003e\n \u003cp\u003e2 (4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.807\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eSmoking status (313)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003cp\u003eCurrent smokers\u003c/p\u003e\n \u003cp\u003eFormer smokers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e88 (28.1)\u003c/p\u003e\n \u003cp\u003e24 (7.7)\u003c/p\u003e\n \u003cp\u003e201 (64.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e87 (32.8)\u003c/p\u003e\n \u003cp\u003e13 (4.9)\u003c/p\u003e\n \u003cp\u003e165 (62.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003cp\u003e11 (22.9)\u003c/p\u003e\n \u003cp\u003e36 (75.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003ePack-year index (225)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e43.4 \u0026plusmn; 23.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e39.8 \u0026plusmn; 22.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e57.0 \u0026plusmn; 21.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026lt;10\u003c/p\u003e\n \u003cp\u003e10-30\u003c/p\u003e\n \u003cp\u003e\u0026gt;30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e11 (3.5)\u003c/p\u003e\n \u003cp\u003e47 (15.0)\u003c/p\u003e\n \u003cp\u003e167 (53.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e10 (5.6)\u003c/p\u003e\n \u003cp\u003e59 (33.2)\u003c/p\u003e\n \u003cp\u003e109 (61.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003cp\u003e4 (8.5)\u003c/p\u003e\n \u003cp\u003e42 (89.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eOccupational exposure (278)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003eNo contact\u003c/p\u003e\n \u003cp\u003eInorganic\u003c/p\u003e\n \u003cp\u003eOrganic\u003c/p\u003e\n \u003cp\u003eMixed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e119 (42.8)\u003c/p\u003e\n \u003cp\u003e71 (25.5)\u003c/p\u003e\n \u003cp\u003e56 (20.2)\u003c/p\u003e\n \u003cp\u003e32 (11.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e97 (40.9)\u003c/p\u003e\n \u003cp\u003e56 (23.6)\u003c/p\u003e\n \u003cp\u003e53 (22.4)\u003c/p\u003e\n \u003cp\u003e31 (13.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e22 (53.7)\u003c/p\u003e\n \u003cp\u003e15 (36.6)\u003c/p\u003e\n \u003cp\u003e3 (7.3)\u003c/p\u003e\n \u003cp\u003e1 (2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.008\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eRadiological pattern (313)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003eCPFE\u003c/p\u003e\n \u003cp\u003eUIP\u003c/p\u003e\n \u003cp\u003efNSIP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e100 (32.0)\u003c/p\u003e\n \u003cp\u003e186 (59.4)\u003c/p\u003e\n \u003cp\u003e27 (8.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e67 (25.3)\u003c/p\u003e\n \u003cp\u003e177 (66.8)\u003c/p\u003e\n \u003cp\u003e21 (7.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e33 (68.7)\u003c/p\u003e\n \u003cp\u003e9 (18.7)\u003c/p\u003e\n \u003cp\u003e6 (12.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eComorbidity (313)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003ePrevalence\u003c/p\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003cp\u003eDyslipidemia\u003c/p\u003e\n \u003cp\u003eOSA\u003c/p\u003e\n \u003cp\u003eAF\u003c/p\u003e\n \u003cp\u003eIHD\u003c/p\u003e\n \u003cp\u003eHeart failure\u003c/p\u003e\n \u003cp\u003ePVD\u003c/p\u003e\n \u003cp\u003eCA\u003c/p\u003e\n \u003cp\u003eDementia\u003c/p\u003e\n \u003cp\u003eCOPD\u003c/p\u003e\n \u003cp\u003eCTD\u003c/p\u003e\n \u003cp\u003eUlcer\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eLiver disease\u003c/p\u003e\n \u003cp\u003eDM\u003c/p\u003e\n \u003cp\u003eHemiparesis\u003c/p\u003e\n \u003cp\u003eKidney disease\u003c/p\u003e\n \u003cp\u003eNeoplasms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e281 (89.8)\u003c/p\u003e\n \u003cp\u003e180 (57.5)\u003c/p\u003e\n \u003cp\u003e162 (51.8)\u003c/p\u003e\n \u003cp\u003e36 (11.5)\u003c/p\u003e\n \u003cp\u003e43 (13.7)\u003c/p\u003e\n \u003cp\u003e64 (20.5)\u003c/p\u003e\n \u003cp\u003e17 (5.4)\u003c/p\u003e\n \u003cp\u003e22 (7.0)\u003c/p\u003e\n \u003cp\u003e17 (5.4)\u003c/p\u003e\n \u003cp\u003e7 (2.2)\u003c/p\u003e\n \u003cp\u003e33 (10.5)\u003c/p\u003e\n \u003cp\u003e16 (5.1)\u003c/p\u003e\n \u003cp\u003e34 (10.9)\u003c/p\u003e\n \u003cp\u003e6 (1.9)\u003c/p\u003e\n \u003cp\u003e73 (23.3)\u003c/p\u003e\n \u003cp\u003e1 (0.3)\u003c/p\u003e\n \u003cp\u003e4 (1.3)\u003c/p\u003e\n \u003cp\u003e77 (24.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e236 (89.1)\u003c/p\u003e\n \u003cp\u003e154 (58.1)\u003c/p\u003e\n \u003cp\u003e142 (53.6)\u003c/p\u003e\n \u003cp\u003e31 (11.7)\u003c/p\u003e\n \u003cp\u003e38 (14.3)\u003c/p\u003e\n \u003cp\u003e56 (21.1)\u003c/p\u003e\n \u003cp\u003e17 (6.4)\u003c/p\u003e\n \u003cp\u003e19 (7.2)\u003c/p\u003e\n \u003cp\u003e14 (5.3)\u003c/p\u003e\n \u003cp\u003e6 (2.3)\u003c/p\u003e\n \u003cp\u003e23 (8.7)\u003c/p\u003e\n \u003cp\u003e11 (4.2)\u003c/p\u003e\n \u003cp\u003e27 (10.2)\u003c/p\u003e\n \u003cp\u003e2 (0.8)\u003c/p\u003e\n \u003cp\u003e59 (22.3)\u003c/p\u003e\n \u003cp\u003e1 (0.4)\u003c/p\u003e\n \u003cp\u003e2 (0.8)\u003c/p\u003e\n \u003cp\u003e51 (19.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e45 (93.8)\u003c/p\u003e\n \u003cp\u003e26 (54.1)\u003c/p\u003e\n \u003cp\u003e20 (41.7)\u003c/p\u003e\n \u003cp\u003e5 (10.4)\u003c/p\u003e\n \u003cp\u003e5 (10.4)\u003c/p\u003e\n \u003cp\u003e8 (16.7)\u003c/p\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003cp\u003e3 (6.3)\u003c/p\u003e\n \u003cp\u003e3 (6.3)\u003c/p\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003cp\u003e10 (20.8)\u003c/p\u003e\n \u003cp\u003e5 (10.4)\u003c/p\u003e\n \u003cp\u003e7 (14.6)\u003c/p\u003e\n \u003cp\u003e4 (8.3)\u003c/p\u003e\n \u003cp\u003e14 (29.2)\u003c/p\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003cp\u003e2 (4.2)\u003c/p\u003e\n \u003cp\u003e26 (54.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e0.441\u003c/p\u003e\n \u003cp\u003e0.611\u003c/p\u003e\n \u003cp\u003e0.128\u003c/p\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003cp\u003e0.649\u003c/p\u003e\n \u003cp\u003e0.480\u003c/p\u003e\n \u003cp\u003e0.085\u003c/p\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003cp\u003e0.732\u003c/p\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.012\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.080\u003c/p\u003e\n \u003cp\u003e0.368\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.006\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.298\u003c/p\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003cp\u003e0.113\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003ePH (241)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMild\u003c/p\u003e\n \u003cp\u003eModerate-severe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e127 (52.7)\u003c/p\u003e\n \u003cp\u003e75 (31.1)\u003c/p\u003e\n \u003cp\u003e39 (16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e100 (49.0)\u003c/p\u003e\n \u003cp\u003e68 (33.3)\u003c/p\u003e\n \u003cp\u003e36 (17.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e27 (73.0)\u003c/p\u003e\n \u003cp\u003e7 (18.9)\u003c/p\u003e\n \u003cp\u003e3 (8.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.033\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eSpirometry (313)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003eFEV1/FVC\u003c/p\u003e\n \u003cp\u003eFEV1 ml\u003c/p\u003e\n \u003cp\u003eFEV1%\u003c/p\u003e\n \u003cp\u003eFVC ml\u003c/p\u003e\n \u003cp\u003eFVC%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e79.7 \u0026plusmn; 10.4\u003c/p\u003e\n \u003cp\u003e2084 \u0026plusmn; 647.2\u003c/p\u003e\n \u003cp\u003e91.9 \u0026plusmn; 22.2\u003c/p\u003e\n \u003cp\u003e2656 \u0026plusmn; 871.9\u003c/p\u003e\n \u003cp\u003e89.4 \u0026plusmn; 20.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e81.2 \u0026plusmn; 9.7\u003c/p\u003e\n \u003cp\u003e2002.6 \u0026plusmn; 650.1\u003c/p\u003e\n \u003cp\u003e92.5 \u0026plusmn; 22.9\u003c/p\u003e\n \u003cp\u003e2560.1 \u0026plusmn; 867.1\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e88.3 \u0026plusmn; 21.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e71.4 \u0026plusmn; 9.9\u003c/p\u003e\n \u003cp\u003e2267.6 \u0026plusmn; 522.2\u003c/p\u003e\n \u003cp\u003e88.9 \u0026plusmn; 18.0\u003c/p\u003e\n \u003cp\u003e3188.8 \u0026plusmn; 694.0\u003c/p\u003e\n \u003cp\u003e95.2 \u0026plusmn; 17.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.024\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.302\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.026\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eDiffusion (286)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003eDLCO%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e57.9 \u0026plusmn; 22.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e58.4 \u0026plusmn; 22.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e55.6 \u0026plusmn; 16.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.451\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026darr;FVC\u0026gt;10% (278)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026darr;FVC\u0026gt;10%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e66 (23.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e59 (24.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e7 (20.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e0.645\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026darr;DLCO\u0026gt;15% (249)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026darr;DLCO\u0026gt;15%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e67 (26.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e60 (27.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e7 (22.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e0.533\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e6MWT (171)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003eDistance\u003c/p\u003e\n \u003cp\u003eInitial SpO2\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFinal SpO2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e405.2 \u0026plusmn; 125.6\u003c/p\u003e\n \u003cp\u003e93.4 \u0026plusmn; 3.3\u003c/p\u003e\n \u003cp\u003e83.9 \u0026plusmn; 8.0\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e397.5 \u0026plusmn; 125.7\u003c/p\u003e\n \u003cp\u003e93.2 \u0026plusmn; 3.5\u003c/p\u003e\n \u003cp\u003e83.5 \u0026plusmn; 8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e474.9 \u0026plusmn; 102.8\u003c/p\u003e\n \u003cp\u003e94.4 \u0026plusmn; 1.4\u003c/p\u003e\n \u003cp\u003e86.9 \u0026plusmn; 6.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.015\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.915\u003c/p\u003e\n \u003cp\u003e0.947\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"7\" valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eTreatment\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003ePrevalence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e184 (58.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e164 (61.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e20 (41.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.031\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003eImmunosuppressants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e37 (11.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e34 (12.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e3 (6.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e0.233\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003eN-acetylcysteine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e95 (30.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e86 (32.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e9 (18.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e0.057\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003eCorticosteroids\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e78 (24.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e71 (26.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e7 (14.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e0.072\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003eC. Low doses\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eC. Medium doses\u003c/p\u003e\n \u003cp\u003eC. High doses\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e25 (8.0)\u003c/p\u003e\n \u003cp\u003e27 (8.6)\u003c/p\u003e\n \u003cp\u003e26 (8.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e22 (8.3)\u003c/p\u003e\n \u003cp\u003e25 (9.4)\u003c/p\u003e\n \u003cp\u003e24 (9.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e3 (6.3)\u003c/p\u003e\n \u003cp\u003e2 (4.2)\u003c/p\u003e\n \u003cp\u003e2 (4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.422\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003eAntifibrotic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e77 (24.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e69 (26.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e8 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e0.165\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003eOxygen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e167 (53.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e150 (56.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e17 (35.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.007\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eMortality (313)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cem\u003eExitus\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e209 (66.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e173 (65.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.7019%;\"\u003e\n \u003cp\u003e36 (75.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.967%;\"\u003e\n \u003cp\u003e0.189\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e\u003cem\u003ep\u003c/em\u003e: Statistically significant results are bolded. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003csup\u003eb\u003c/sup\u003eCorticosteroids: low doses \u0026lt;7.5 mg/day, medium doses: 7.5-30 mg/day, high doses: \u0026gt;30 mg/day.\u003c/p\u003e\n\u003cp\u003eAbbreviations: cf-IIP, chronic fibrosing idiopathic interstitial pneumonia; LC, lung cancer; \u003cem\u003ep\u003c/em\u003e, statistical significance; SD, standard deviation; BMI, body mass index; CPFE, combined pulmonary fibrosis and emphysema; UIP, usual interstitial pneumonia; fNSIP, fibrotic nonspecific interstitial pneumonia; OAS, obstructive sleep apnoea; AF, atrial fibrillation; IHD, ischaemic heart disease; PVD, peripheral vascular disease; CA, cerebrovascular accident; COPD, chronic obstructive pulmonary disease; CTD, connective tissue disease; DM, diabetes \u003cem\u003emellitus\u003c/em\u003e; PH, pulmonary hypertension; FEV1, forced expiratory volume in one second; FVC, forced vital capacity; DLCO, diffusing capacity for carbon monoxide; 6MWT, 6-min walking test; SpO2, percutaneous oxygen saturation.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u003c/strong\u003e Incidence rate of all‑cause mortality according to different variables in patients with cf-IIP.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatient-year\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eExitus\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eTotal series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1589.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e131.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e114.8-150.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e381.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e139.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e106.3-182.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1208.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e156\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e129.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e110.3-151.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eAge \u0026lt; 64.9 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e252.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e87.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e57.3-132.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eAge 65-69.9 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e291.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e109.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e77.7-155.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eAge 70-74.9 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e449.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e109.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e82.4-144.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eAge \u0026gt; 75 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e596.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e177.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e147.0-215.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eNever smoker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e474.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e145.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e114.9-184.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eCurrent smoker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e127.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e101.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e59.1-175.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eFormer smoker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e987.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e127\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e128.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e108.1-153.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eBMI \u0026lt; 24.9 kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e275.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e155.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e115.6-210.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eBMI: 25-29.9 kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e821.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e126.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e104.5-153.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eBMI: 30-34.9 kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e420.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e130.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e100.5-170.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eBMI \u0026ge; 35 kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e72.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e96.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e46.1-202.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eCPFE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e494.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e147.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e117.4-185.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eUIP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e902.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e130.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e109.1-156.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003efNSIP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e192.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e93.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e58.9-148.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eWith comorbidity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1448.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e127.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e110.0-146.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eMild PH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e380.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e139.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e106.3-182.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eModerate/severe PH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e181.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e204.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e148.0-282.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eNot PH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e697.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e106.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e84.5-133.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eNot COPD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1432.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e187\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e130.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e113.1-150.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eCOPD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e156.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e140.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e92.3-212.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eWithout neoplasms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1215.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e160\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e131.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e112.7-153.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eNeoplasms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e374.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e131.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e99.0-173.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eWithout LC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1514.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e173\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e114.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e98.4-132.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eLC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e75.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e478.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e345.4-663.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eFVC baseline\u0026gt;80%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1148.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e108.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e91.3-129.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eFVC baseline\u0026lt;80%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e440.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e190.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e153.8-235.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eDLCO baseline\u0026gt;60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e882.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e99.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e80.9-122.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eDLCO baseline \u0026lt;60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e706.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e171.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e143.3-204.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003e\u0026darr;\u0026le;\u0026nbsp;10% FVC per year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1198.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e104.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e87.6-124.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003e\u0026darr;\u0026gt; 10% FVC per year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e312.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e182.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e140.5-236.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003e\u0026darr;\u0026le;\u0026nbsp;15% DLCO per year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e756.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e78.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e60.4-100.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003e\u0026darr;\u0026gt; 15% DLCO per year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e753.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e169.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e142.8-201.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003e6MWT \u0026gt; 250 m\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1508.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e187\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e123.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e107.4-143.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003e6MWT \u0026lt; 250 m\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e80.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e272.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e179.5-414.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eWithout treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e556.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e122.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e96.4-155.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eImmunosuppressants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e194.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e159.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e112.3-227.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eCorticosteroids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e402.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e166.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e131.1-211.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eN-acetylcysteine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e560.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e144.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e116.1-179.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003ePreantifibrotic\u003c/p\u003e\n \u003cp\u003ecombination\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e584.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e165.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e136.0-202.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eAntifibrotics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e271.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e107.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e74.4-154.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eCombination + antifibrotic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e177.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e84.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e50.9-140.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eOxygen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e825.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e180.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e153.7-211.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: CI, confidence interval; BMI, body mass index; CPFE, combined pulmonary fibrosis and emphysema; UIP, usual interstitial pneumonia; fNSIP, fibrotic nonspecific interstitial pneumonia; PH, pulmonary hypertension; COPD, chronic obstructive pulmonary disease; LC, lung cancer; FVC, forced vital capacity; DLCO, diffusing capacity for carbon monoxide; 6MWT, 6-min walking test.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u003c/strong\u003e Univariate analysis for mortality.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"575\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eVariable n: 344\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eHR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.71-1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.853\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026lt; 65 years\u003c/p\u003e\n \u003cp\u003e65-69.9 years\u003c/p\u003e\n \u003cp\u003e70-74.9 years\u003c/p\u003e\n \u003cp\u003e\u0026ge;75 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e1.36\u003c/p\u003e\n \u003cp\u003e1.38\u003c/p\u003e\n \u003cp\u003e2.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.87-2.35\u003c/p\u003e\n \u003cp\u003e0.85-2.24\u003c/p\u003e\n \u003cp\u003e1.67-4.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.271\u003c/p\u003e\n \u003cp\u003e0.195\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026lt; 24.9 kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003cp\u003e25-29.9 kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003cp\u003e30-34.9 kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003cp\u003e\u0026ge; 35 kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003cp\u003e0.80\u003c/p\u003e\n \u003cp\u003e0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.56-1.11\u003c/p\u003e\n \u003cp\u003e0.55-1.17\u003c/p\u003e\n \u003cp\u003e0.32-1.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.178\u003c/p\u003e\n \u003cp\u003e0.251\u003c/p\u003e\n \u003cp\u003e0.191\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eSmoking status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eNever smoker\u003c/p\u003e\n \u003cp\u003eCurrent smoker\u003c/p\u003e\n \u003cp\u003eFormer smoker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e0.65\u003c/p\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.35-1.21\u003c/p\u003e\n \u003cp\u003e0.70-1.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.175\u003c/p\u003e\n \u003cp\u003e0.672\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eOccupational exposure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eNo contact\u003c/p\u003e\n \u003cp\u003eInorganic\u003c/p\u003e\n \u003cp\u003eOrganic\u003c/p\u003e\n \u003cp\u003eMixed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e1.25\u003c/p\u003e\n \u003cp\u003e0.90\u003c/p\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.87-1.80\u003c/p\u003e\n \u003cp\u003e0.60-1.35\u003c/p\u003e\n \u003cp\u003e0.48-1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.226\u003c/p\u003e\n \u003cp\u003e0.619\u003c/p\u003e\n \u003cp\u003e0.111\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eRadiological pattern\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eUIP\u003c/p\u003e\n \u003cp\u003eCPFE\u003c/p\u003e\n \u003cp\u003efNSIP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e1.10\u003c/p\u003e\n \u003cp\u003e0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.82-1.48\u003c/p\u003e\n \u003cp\u003e0.39-1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.518\u003c/p\u003e\n \u003cp\u003e0.052\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eComorbidity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.44-1.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.064\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eCOPD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.66-1.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.838\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003ePH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eMild\u003c/p\u003e\n \u003cp\u003eModerate/severe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e1.38\u003c/p\u003e\n \u003cp\u003e1.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.99-1.92\u003c/p\u003e\n \u003cp\u003e1.25-3.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.055\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eNeoplasms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.72-1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.954\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eLC during the study period\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e4.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e2.67-6.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eLC staging\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eStage I-II\u003c/p\u003e\n \u003cp\u003eStage III\u003c/p\u003e\n \u003cp\u003eStage IV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e1.78\u003c/p\u003e\n \u003cp\u003e4.47\u003c/p\u003e\n \u003cp\u003e8.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.86-3.71\u003c/p\u003e\n \u003cp\u003e2.30-8.68\u003c/p\u003e\n \u003cp\u003e4.41-17.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.122\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eFEV1/FVC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026ge;70\u003c/p\u003e\n \u003cp\u003e\u0026lt;70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e1.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.69-1.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.755\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eFEV1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026ge;80\u003c/p\u003e\n \u003cp\u003e\u0026lt;80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e1.01-1.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eFVC%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026ge;80\u003c/p\u003e\n \u003cp\u003e\u0026lt;80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e1.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e1.41-2.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eDLCO%\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026ge;60%\u003c/p\u003e\n \u003cp\u003e\u0026lt;60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e1.52-2.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eDistance travelled (6MWT)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026ge;250 m\u003c/p\u003e\n \u003cp\u003e\u0026lt;250 m\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e2.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e1.64-3.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eTreatment\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003ePrefibrotic\u003c/p\u003e\n \u003cp\u003eAntifibrotic\u003c/p\u003e\n \u003cp\u003eMixed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e1.33\u003c/p\u003e\n \u003cp\u003e0.91\u003c/p\u003e\n \u003cp\u003e0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.96-1.85\u003c/p\u003e\n \u003cp\u003e0.58-1.42\u003c/p\u003e\n \u003cp\u003e0.38-1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.087\u003c/p\u003e\n \u003cp\u003e0.669\u003c/p\u003e\n \u003cp\u003e0.079\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eImmunosuppressants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e1.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.80-1.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.380\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eN-acetylcysteine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.84-14.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.491\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eCorticosteroids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e1.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e1.05-1.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.021\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eAntifibrotic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eSi\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.48-0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.013\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eOxygen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e2.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e1.72-3.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003eTo take into account the longitudinal study: 313 patients plus the 31 determinations of patients with cf-IIP who develop LC nonsimultaneously.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003eb\u003c/sup\u003eStatistically significant results are bolded. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ec\u003c/sup\u003eThere were only 321 measurements, so longitudinal DLCO was not considered.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAbbreviations: HR, hazard ratio; CI, confidence interval; \u003cem\u003ep\u003c/em\u003e, statistical significance; BMI, body mass index; UIP, usual interstitial pneumonia; CPFE, combined pulmonary fibrosis and emphysema; fNSIP, fibrotic nonspecific interstitial pneumonia; COPD, chronic obstructive pulmonary disease; PH, pulmonary hypertension; LC, lung cancer; FEV1, forced expiratory volume in one second; FVC, forced vital capacity; DLCO, diffusing capacity for carbon monoxide; 6MWT, 6-min walking test.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4.\u003c/strong\u003e Multivariate Cox regression analysis in the research population.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"567\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.60-1.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.639\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026ge;75 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1.00-1.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.023\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eSmoking status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eCurrent smoker\u003c/p\u003e\n \u003cp\u003eFormer smoker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.80\u003c/p\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.41-1.56\u003c/p\u003e\n \u003cp\u003e0.60-1.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.512\u003c/p\u003e\n \u003cp\u003e0.539\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eRadiological pattern\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eCPFE\u003c/p\u003e\n \u003cp\u003efNSIP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1.04\u003c/p\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.73-1.47\u003c/p\u003e\n \u003cp\u003e0.43-1.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.831\u003c/p\u003e\n \u003cp\u003e0.061\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eLC staging\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eStage I-II\u003c/p\u003e\n \u003cp\u003eStage III\u003c/p\u003e\n \u003cp\u003eStage IV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1.77\u003c/p\u003e\n \u003cp\u003e4.32\u003c/p\u003e\n \u003cp\u003e10.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.84-3.73\u003c/p\u003e\n \u003cp\u003e2.03-9.18\u003c/p\u003e\n \u003cp\u003e3.86-27.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.132\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eDistance 6MWT\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026lt; 250 m\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1.47-3.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eFVC%\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026lt; 80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1.39-2.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eDLCO%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026ge; 60\u003c/p\u003e\n \u003cp\u003e\u0026lt; 60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003cp\u003e1.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.53-1.08\u003c/p\u003e\n \u003cp\u003e0.90-3.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.125\u003c/p\u003e\n \u003cp\u003e0.103\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eTreatment\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eAntifibrotic\u003c/p\u003e\n \u003cp\u003eOxygen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.60\u003c/p\u003e\n \u003cp\u003e1.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.43-0.84\u003c/p\u003e\n \u003cp\u003e1.33-2.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e Statistically significant results are bolded. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAbbreviations: HR, hazard ratio; CI, confidence interval; \u003cem\u003ep\u003c/em\u003e, statistical significance; CPFE, combined pulmonary fibrosis and emphysema; fNSIP, fibrotic nonspecific interstitial pneumonia; LC, lung cancer; 6MWT, 6-min walking test; FVC, forced vital capacity; DLCO, diffusing capacity for carbon monoxide.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5\u003c/strong\u003e. Treatments regimens for patients with lung cancer and cf-IIP included in the study.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 243px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTreatment\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en: 48 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eI-II Stage\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en: 15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIII Stage\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en: 18\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIV Stage\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en: 15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 243px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurgery and combinations, n: 13 (27.1)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e9 (60.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e4 (22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 243px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChemotherapy and combinations, n: 21 (43.7)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e9 (50.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e12 (80.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 243px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRadiotherapy \u0026plusmn; immunotherapy, n: 6 (12.5)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e4 (26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e2 (11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 243px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePalliative care, n: 8 (16.7)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e2 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e3 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e3 (20.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eData are expressed as n (%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6.\u003c/strong\u003e Lung function results. Comparison with the studies of Kato (2018)\u003csup\u003e32\u003c/sup\u003e and Yoo (2019)\u003csup\u003e38\u003c/sup\u003e.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"604\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026ldquo;XXX\u0026rdquo;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 254px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKato et al.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ecf-IIP without LC n: 265\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ecf-IIP \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; with LC \u0026nbsp; \u0026nbsp; \u0026nbsp;n: 48 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIPF \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; without LC \u0026nbsp; n: 562\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIPF \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;with LC \u0026nbsp; n: 70\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eSpirometry\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFEV1/FVC\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFEV1%\u003c/p\u003e\n \u003cp\u003eFVC%\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e265 (100)\u003c/p\u003e\n \u003cp\u003e81.2 \u0026plusmn; 9.7\u003c/p\u003e\n \u003cp\u003e92.5 \u0026plusmn; 22.9\u003c/p\u003e\n \u003cp\u003e88.3 \u0026plusmn; 21.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e48 (100)\u003c/p\u003e\n \u003cp\u003e71.4 \u0026plusmn; 9.9\u003c/p\u003e\n \u003cp\u003e88.9 \u0026plusmn; 18.0\u003c/p\u003e\n \u003cp\u003e95.2 \u0026plusmn; 17.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.302\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.026\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e562 (100)\u003c/p\u003e\n \u003cp\u003e80.9 \u0026plusmn; 10.7\u003c/p\u003e\n \u003cp\u003e----\u003c/p\u003e\n \u003cp\u003e75.1 \u0026plusmn; 20.1\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e70 (100)\u003c/p\u003e\n \u003cp\u003e74.1 \u0026plusmn; 9.4\u003c/p\u003e\n \u003cp\u003e----\u003c/p\u003e\n \u003cp\u003e89.2 \u0026plusmn; 16.9\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e---\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eDiffusion\u003c/p\u003e\n \u003cp\u003eDLCO%\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e243 (91.7)\u003c/p\u003e\n \u003cp\u003e58.4 \u0026plusmn; 22.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e43 (89.6)\u003c/p\u003e\n \u003cp\u003e55.6 \u0026plusmn; 16.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.451\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e562 (100)\u003c/p\u003e\n \u003cp\u003e76.6 \u0026plusmn; 23.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e70 (100)\u003c/p\u003e\n \u003cp\u003e74.9 \u0026plusmn; 26.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.517\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026ldquo;XXX\u0026rdquo;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 254px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYoo et al.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ecf-IIP without LC\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en: 265\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ecf-IIP \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;with LC\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en: 48\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIPF \u0026nbsp; \u0026nbsp; \u0026nbsp;without LC\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en: 803\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIPF \u0026nbsp; \u0026nbsp; \u0026nbsp; with LC\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en: 135\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eSpirometry-year\u003c/p\u003e\n \u003cp\u003e\u0026darr;FVC\u0026gt;10%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e244 (92.1)\u003c/p\u003e\n \u003cp\u003e59 (24.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e34 (70.8)\u003c/p\u003e\n \u003cp\u003e7 (20.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.645\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e599 (74.6)\u003c/p\u003e\n \u003cp\u003e130 (21.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e92 (68.1)\u003c/p\u003e\n \u003cp\u003e18 (19.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.642\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;Diffusion-year\u003c/p\u003e\n \u003cp\u003e\u0026darr;DLCO\u0026gt;15%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e215 (81.1)\u003c/p\u003e\n \u003cp\u003e60 (27.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e31 (64.6)\u003c/p\u003e\n \u003cp\u003e7 (22.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.533\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e490 (61.0)\u003c/p\u003e\n \u003cp\u003e120 (24.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e81 (60.0)\u003c/p\u003e\n \u003cp\u003e12 (14.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.056\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe data are expressed as n (%) and the mean\u0026nbsp;\u0026plusmn;\u0026nbsp;standard deviation.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003eStatistically significant results are bolded. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAbbreviations: Cf-IIP,\u0026nbsp;chronic fibrosing idiopathic interstitial pneumonia;\u0026nbsp;LC, lung cancer; IPF,\u0026nbsp;Idiopathic pulmonary fibrosis; \u003cem\u003ep\u003c/em\u003e, statistical significance; FEV1, forced expiratory volume in one second; FVC, forced vital capacity; DLCO, diffusing capacity for carbon monoxide. (---): data not evaluated.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Hospital Clínico San Carlos","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"interstitial lung disease, idiopathic pulmonary fibrosis, usual interstitial pneumonia, fibrotic nonspecific interstitial pneumonia, combined pulmonary fibrosis and emphysema, lung cancer","lastPublishedDoi":"10.21203/rs.3.rs-5876050/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5876050/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground. \u003c/strong\u003eThe coexistence of chronic fibrosing idiopathic interstitial pneumonia (cf-IIP) and lung cancer (LC) in the same patient raises many doubts regarding patient prognosis and complicates decision-making in multidisciplinary thoracic committees.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResearch questions. \u003c/strong\u003eTo provide new insights into the management and prognosis of patients with cf-IIP, we assessed the sociodemographic and clinical differences between patients with and without LC to evaluate their role in their mortality. Other factors were also studied.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods. \u003c/strong\u003eA longitudinal study was conducted from January 1, 2001, to December 31, 2020, in “XXX”. All patients who attended the interstitial lung disease multidisciplinary unit and had a medical diagnosis of cf-IIP were included. The primary outcome was all-cause mortality. The independent variable was the presence of LC. Covariates: sociodemographic, clinical, and therapeutic variables. The mortality rate (MR) was expressed per 1000 patient-years with a 95% confidence interval (CI). Cox multiple regression analysis examined the influence of LC and other covariates on mortality. The results are expressed as hazard ratios (HRs) with CIs.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults. \u003c/strong\u003eA total of\u003cstrong\u003e \u003c/strong\u003e313 patients with cf-IIP were included, with a follow‑up of 1589.6 patient‑years. There were 209 (66.8%) deaths. The MR was 131.5 (114.8-150.6), and 50% of patients died at 5.58 years from cf-IIP diagnosis. After adjusting for confounders, LC was associated with a significantly increased risk of mortality (HR: 4.11; 2.50-6.77; p = 0.000), whereas antifibrotic treatment was the only factor that decreased the risk of mortality (HR: 0.60; 0.43-0.84; p = 0.003). The prevalence of LC was 15.3%. The most common histopathological type was squamous cell carcinoma (39.6%). At diagnosis, 68.7% of LC cases were in stages III-IV. The most widely used treatment was chemotherapy and its combination (43.7%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions. \u003c/strong\u003ePatients with cf-IIP who developed LC had a fourfold increased risk of mortality and shorter mean survival (two years versus six years) compared with those without LC. Therefore, we recommend LC screening in these patients.\u003c/p\u003e","manuscriptTitle":"Mortality rate in chronic fibrosing idiopathic interstitial pneumonia: the role of lung cancer","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-01-22 08:27:01","doi":"10.21203/rs.3.rs-5876050/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a66885e4-7cda-4c24-a2aa-ac79be77389c","owner":[],"postedDate":"January 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":43213586,"name":"Pulmonology"}],"tags":[],"updatedAt":"2025-01-29T03:53:07+00:00","versionOfRecord":[],"versionCreatedAt":"2025-01-22 08:27:01","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5876050","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5876050","identity":"rs-5876050","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}