Lung Cancer |

Significance of Diffuse Pulmonary Infiltrates in Patients With Lung Cancer FREE TO VIEW

Elvina Khusainova; Robert Lee; Diane Stover
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Memorial Sloan Kettering Cancer Center, New York, NY

Chest. 2014;146(4_MeetingAbstracts):602A. doi:10.1378/chest.1992206
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SESSION TITLE: Lung Cancer Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Pulmonary infiltrates in lung cancer patients can represent a number of diagnoses including infectious pneumonia, drug/radiation pneumonitis, and/or progression of disease. Only sparse information is available describing the nature of infiltrates and outcome in this population. We designed a study to further improve understanding of this particular process in lung cancer patients.

METHODS: We performed a retrospective chart review of patients admitted to a major teaching cancer center with a combined diagnosis of abnormal radiograph/pneumonia and lung cancer from January 2008 to December 2010. Data including patient demographics, cancer type and treatment received, hospital course, and survival were reviewed.

RESULTS: A total of 84 admissions in 24 men (44%) and 31 (56%) women were studied. Age on admission ranged from 41 to 87 years old (mean age=66.7). The most common histological type of lung cancer was adenocarcinoma (42%), followed by squamous cell carcinoma (13%). 68% of patients had stage IV lung cancer. In 64 % of cases patients received chemotherapy and/or radiation treatment in the preceding 3 months. The mean hospital stay was 8 days (range 3 days to 60 days). In 42% of cases radiographs were consistent with bilateral infiltrates. 35% of unilateral infiltrates were ipsilateral to the site of original lung cancer. 12% of admissions led to respiratory failure requiring mechanical ventilation. In 85% of cases microbiologic work up yielded no specific causative organism. All patients received antibiotics. Bronchoscopy was performed in 11% of all cases, with three cases showing progression of disease. 85% of admissions led to home discharge. Five patients were discharged to hospice, eight patients died in the hospital.

CONCLUSIONS: Etiology of pulmonary infiltrates remained unclear in the majority of lung cancer patients. Bilateral infiltrates did not lead to worsening outcome since most deaths occurred in patients with unilateral infiltrates. Respiratory failure requiring intubation on initial presentation was an indicator for mortality during hospitalization. Although bronchoscopy was rarely performed, when it was, it showed clinically significant findings, such as progression of disease.

CLINICAL IMPLICATIONS: Since the majority of patients with lung cancer had a good outcome, they should be aggressively treated when presenting with new pulmonary infiltrates. When clinically appropriate, bronchoscopy should be performed as it may reveal significant findings such as progression of disease.

DISCLOSURE: The following authors have nothing to disclose: Elvina Khusainova, Robert Lee, Diane Stover

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