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This study evaluated the prognostic value of a newly proposed surgical indicator\u2014the predicted ILD Gender\u2013Age\u2013Physiology (GAP) stage\u2014which incorporates predicted postoperative pulmonary function into the conventional ILD-GAP stage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study retrospectively analyzed 125 patients with clinical stage 1 lung cancer and ILD who underwent surgery during 2011\u20132023. Postoperative outcomes were compared according to surgical procedure and predicted ILD-GAP stage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 5-year overall survival (OS) rate was markedly superior in patients who underwent anatomical resection with a predicted ILD-GAP stage\u2009\u2264\u20092 than in those who underwent wedge resection (75.0% vs. 21.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In contrast, survival did not differ between anatomical resection with a predicted ILD-GAP stage 3 and wedge resection (27.8% vs. 21.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.934). Multivariate analysis identified diffusing capacity of carbon monoxide (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043), anatomical resection with a predicted ILD-GAP stage\u2009\u2264\u20092 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009), and pathological stage 1 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035) as independent predictors of prognosis. Furthermore, the predicted ILD-GAP stage provided superior prognostic accuracy for 5-year OS compared with the original ILD-GAP stage (area under the curve: 0.735 vs. 0.653;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The proposed surgical indicator enhanced prognostic stratification in lung cancer patients with ILD. In particular, anatomical lung resection in patients with a predicted ILD-GAP stage\u2009\u2264\u20092 was identified as an independent favorable prognostic factor for 5-year OS, highlighting the importance of surgical planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10147-026-03164-2","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T16:51:13Z","timestamp":1787331073000},"page":"2524-2534","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of a new surgical indicator for lung cancer with interstitial lung disease based on the gender\u2013age\u2013physiology staging system"],"prefix":"10.1007","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3049-5732","authenticated-orcid":false,"given":"Yoshito","family":"Imamura","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8862-9222","authenticated-orcid":false,"given":"Keita","family":"Nakanishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heng","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minoru","family":"Sugihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taiki","family":"Ryo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhisa","family":"Ichikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Masuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Takenaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Kawasumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuka","family":"Kadomatsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harushi","family":"Ueno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taketo","family":"Kato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shota","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Mizuno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toyofumi Fengshi","family":"Chen-Yoshikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"3164_CR1","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.jtcvs.2014.08.086","volume":"149","author":"T Sato","year":"2015","unstructured":"Sato T, Watanabe A, Kondo H et al (2015) Long-term results and predictors of survival after surgical resection of patients with lung cancer and interstitial lung diseases. 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