Comparison of survival of chronic obstructive pulmonary disease patients with or without a localized non-small cell lung cancer.
Chronic obstructive pulmonary disease (COPD) and non-small cell lung cancer (NSCLC) are often co-existing diseases with poor prognosis. The aim of this study was to compare survival in COPD patients with localized NSCLC treated with stereotactic body radiotherapy (NSCLC group) with COPD patients without a malignant diagnosis (non-malignant group).



The NSCLC group was prospectively recorded at the Department of Oncology from 2007 to 2013. The non-malignant group was selected among patients referred to the Department of Respiratory Medicine from 2005 until 2011 suspected of thoracic malignancy but without the malignant diagnosis maintained.



In a propensity score matched comparison the median overall survival was 53 vs. 71 months in the NSCLC and non-malignant groups, respectively (p<0.001). Subgroup analyses showed survival for patients with mild/moderate COPD was affected statistically significant with a higher mortality rate by a diagnosis of localized NSCLC with hazard ratio=2.62 (95% CI: 1.47-4.68) while an insignificant higher mortality rate with hazard ratio=1.22 (95% CI: 0.71-2.08) was found in patient with severe/very severe COPD.



Despite the serious prognosis of COPD, a localized NSCLC diagnosis negatively affects survival in COPD patients. However, stereotactic body radiotherapy should still be considered for COPD patients diagnosed with localized NSCLC.
Department of Oncology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark; Institute of Clinical Research, University of Southern Denmark, Winsløwparken 19.3, 5000 Odense C, Denmark. Electronic address: stefan.jeppesen@rsyd.dk.
Stefan S
SS
Jeppesen
Department of Respiratory Medicine, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark. Electronic address: nc.hansen@dadlnet.dk.
Niels-Chr G
NG
Hansen
Department of Oncology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark. Electronic address: tine.schytte@rsyd.dk.
Tine
T
Schytte
Laboratory of Radiation Physics, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark. Electronic address: morten.nielsen@rsyd.dk.
Morten
M
Nielsen
Department of Oncology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark; Institute of Clinical Research, University of Southern Denmark, Winsløwparken 19.3, 5000 Odense C, Denmark. Electronic address: olfred.hansen@rsyd.dk.
Olfred
O
Hansen
D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000401:mortality / Q000473:pathology; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D016634:Radiosurgery / Q000379:methods; D015996:Survival Rate
COPD; SBRT; early stage lung cancer; non-small cell lung cancer; survival