Preoperative brain natriuretic peptide levels are associated with postoperative all-cause mortality in patients with lung cancer

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Abstract
Purpose Serum levels of cardiovascular markers, including brain natriuretic peptide (BNP), are associated with the prognosis of cancer patients. This study examined the relationship between the preoperative blood BNP level and the long-term prognosis after curative lung cancer resection. Methods Patients who underwent radical resection for lung cancer at our institution between January 2012 and June 2019 were divided into the high- (≥ 18.5 pg/ml) and low- (< 18.5 pg/ml) BNP groups. Kaplan–Meier curves were used to analyze the postoperative overall survival (OS) and relapse-free survival (RFS). The cumulative incidence function (CIF) was analyzed using the Gray’s test. Univariate and multivariate Cox proportional hazards models were used to identify independent predictors of the OS. Results The postoperative OS was significantly worse in the high-BNP group than in the low-BNP group (p = 0.03), but there was no statistically significant difference in the RFS (p = 0.09). A CIF analysis indicated that non-cancer-related deaths had a greater impact on the RFS than cancer recurrence. Blood BNP levels possibly affected the OS independently (hazard ratio, 1.50). Conclusions Preoperative BNP levels in patients with lung cancer may indicate a potentially compromised condition and can be associated with the postoperative OS. However, the link between the BNP level and lung cancer severity remains unclear.

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