SESSION TITLE: COPD II
SESSION TYPE: Slide Presentations
PRESENTED ON: Monday, March 24, 2014 at 09:00 AM - 10:00 AM
PURPOSE: Our goal has been to assess the presence of neoplasms in a cohort of COPD patients, to describe their clinical and epidemiological characteristics and observe if there are differences between COPD patients with neoplasms and those without them.
METHODS: Large cohort of COPD patients admitted between July 2006 and February 2011. Three groups were established during the first admission in this period: COPD without cancer, with pulmonary and extrapulmonary malignancy. We collected multiple socio-demographic and clinical variables including whether or not they belonged to a specific phenotype.
RESULTS: 486 patients were included (92% men, average age 67,5 ± 9,6 years). 120 patients had cancer (24,7%): 60 extrapulmonary and 60 pulmonary. The most frequent histological types were: Squamous cell 26,6%, Adenocarcinoma 19%, Undifferentiated Large cell 15,8% and Transitional cell 10,8%. Cancer patients were older (70,9 ± 7,4 vs 66,4 ± 9,4 years; p = 0,005), with higher smoking level in p/year (66,7 ± 28,3 vs 58,9 ± 26; p = 0,02), lower previous diagnosis of COPD (40,8% vs 53,8%; p = 0,01), more associated comorbidities (89,1% vs 78,1%; p = 0,01), lower GOLD stage (GOLD IV 18% vs 30,1%), lower degree of dyspnea MRC (p = 0,0005) and better FEV1% (p = 0,028). No relationship with the presence of a specific phenotype was found. Comparing patients with pulmonary and extrapulmonary cancer, it was more frequent (p < 0,05) a diagnosis of COPD in the current admission (68,3% vs 50%; p = 0,006) and lower percentage of comorbidities in the first group.
CONCLUSIONS: 1.- In our experience Cancer in COPD patients was frequent (24,7%), mostly of pulmonary origin. 2.- COPD patients with Cancer were older, with a higher level of smoking and with more comorbidities, despite that they were more underdiagnosed and had lower functional impairment. 3.- The under-diagnosis of COPD among patients with lung cancer was very high (68,3%).
CLINICAL IMPLICATIONS: The association between COPD and lung cancer is independent of age or level of smoking and multiplies between 2-5 times the risk of cancer in these patients.
DISCLOSURE: The following authors have nothing to disclose: María del Carmen García García, Jacinto Hernández Borge, Pedro Pires Goncalves, Lourdes Cañón Barroso, Estefanía Molina Ortiz, Ana Castañar Jover, Francisca Lourdes Márquez Pérez, María José Antona Rodríguez, José Antonio Gutierrez Lara, Ignacio Rodríguez Blanco
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