How does chronic obstructive pulmonary disease affect survival of patients with stage 4 lung cancer?

Lung Cancer

Clin Respir J. 2020 Jul 24. doi: 10.1111/crj.13237. Online ahead of print.


BACKGROUND: Lung cancer risk is increased in COPD. However, it is not clear how COPD affects the course of lung cancer.

AIM: To determine whether overall survival of stage 4 lung cancer patients differ in various COPD stages.

STUDY DESIGN: A cross-sectional retrospective study.

METHODS: We screened lung cancer patients with ICD code: C34 and included stage 4 lung cancer patients with histological diagnosis and pulmonary function tests at admission in the study. Demographic data, stages, metastasis sites and number of metastases, performance status, pulmonary function tests, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages, arterial blood gasses and treatment methods were recorded on a standardized database. We checked their dates of death from national database. Data were evaluated with SPSS program version 18.

RESULTS: Out of 900 patients, 146 patients had stage 4 disease at the time of diagnosis and, 127 patients had COPD. There was a significant difference between survivals of stage 4 cancer patients with different COPD stages. As COPD stage increased, overall survival worsened (p = 0.037). Factors affecting survival were bone metastasis (p = 0.01, OR = 1.72), liver metastasis (p = 0.04, OR = 1.87), brain metastasis (p = 0.001, OR = 2.6), having N 2-3 disease (p = 0.01, OR = 1.79) and GOLD 4 COPD (p = 0.01, OR = 2.28).

CONCLUSION: As COPD becomes more severe, overall survival rates of stage 4 patients worsen. Bone metastasis, liver metastasis, brain metastasis, having N2-3 disease and GOLD 4 COPD worsen overall survival.