title: Characteristics of elderly patients with COPD and newly diagnosed lung cancer, and factors associated with treatment decision.
abstract: OBJECTIVE
  To investigate the clinical features, diagnosis, and treatment status of elderly patients with chronic obstructive pulmonary disease (COPD) complicated with lung cancer.
  
  
  METHODS
  This was a retrospective study of 206 patients aged >60 years with COPD and newly diagnosed lung cancer at the Tianjin Chest Hospital Respiratory Centre between September 2008 and September 2013. Lung function, radiology, and clinical data were retrieved.
  
  
  RESULTS
  Among all patients, 57% (117/206) were hospitalized due to acute COPD aggravation, 47% (96/206) had COPD grade III or IV, 95% (195/206), showed diffusion dysfunction in pulmonary function examination, 90% (185/206) had a history of smoking, and 26% (54/206) were treated with inhaled corticosteroids for COPD treatment. Ninety-eight patients suffered from squamous carcinoma, 73 from adenocarcinoma, and 35 from small-cell carcinoma. Clinical staging was I in 36 patients, II in 47 patients, III in 78 patients, and IV in 45 patients. Initial treatments were surgery in 59 patients, chemotherapy in 30 patients, and no treatment in 117 patients. Multivariate analysis showed that age (P<0.001), COPD grades (P=0.01), clinical staging (P<0.001), and pulmonary diffusion function (P=0.007) were independent factors associated with patients with COPD being given treatments for lung cancer.
  
  
  CONCLUSIONS
  Younger patients with lower COPD grades, earlier lung cancer stage, and better pulmonary diffusion function are more likely to receive treatments.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital, Tianjin, People's Republic of China.
authors.forename: Jianwen
authors.initials: J
authors.lastname: Qin
authors.affiliation: Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital, Tianjin, People's Republic of China.
authors.forename: Guangsheng
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital, Tianjin, People's Republic of China.
authors.forename: Jingmin
authors.initials: J
authors.lastname: Zhou
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D000077192:Adenocarcinoma of Lung; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D002681:China / Q000453:epidemiology; D000066491:Clinical Decision-Making; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008168:Lung / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D008175:Lung Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D016017:Odds Ratio; D018579:Patient Selection; D011013:Pneumonectomy; D011653:Pulmonary Diffusing Capacity; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors; D055752:Small Cell Lung Carcinoma / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D012907:Smoking / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents; D001993:Bronchodilator Agents
keywords: chronic obstructive pulmonary disease; diagnosis; lung cancer; treatment