Author of

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  P1.22 - Poster Session 1 - Epidemiology, Etiology (ID 166)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Prevention & Epidemiology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10994

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    P1.22-010 - Goddard classification is associated with clinical characteristics in patients with COPD and advanced NSCLC. (ID 2726)

    09:30 - 09:30  |  Author(s): K. Asai
    • Abstract

    Background
    Chronic obstructive pulmonary disease (COPD) is a frequent complication seen in 24.9% in patients with lung cancer. In practice, a decreased respiratory function due to COPD influences to decision of treatment. The airway obstruction is assessed by the Global Initiative for obstructive lung disease (GOLD) classification. On the other hand, Goddard classification is a method for evaluating the emphysema using CT images. The respiratory function of an advanced lung cancer has various modifications such as tumor airway obstruction or atelectasis. The hypothesis is that in patient with COPD and advanced lung cancer patients, GOLD classification may not correspond to the Goddard classification. We evaluated the associations of clinical characteristics with Goddard classification as well as GOLD classification.

    Methods
    Between May 2007 and April 2012, the pre-treatment respiratory function was assessed for patients diagnosed at Osaka City University Hospital as non-small cell lung cancer stage IIIB or IV without EGFR gene active mutations. FEV/FVC% less than 70% were diagnosed for COPD. GOLD and Goddard classification were evaluated. Two doctors independently determined the Goddard classification, and the final score was adopted from the average of two scores. The association of clinical characteristics with Goddard classification as well as GOLD classification was performed by fisher exact test. An univariate analysis was performed to evaluate the prognosis by COX regression method. In multivariate analysis, histology, stage, number of cigarette smoking, and FEV/FVC% were performed to evaluate the prognosis by COX regression selected variable method (stepwise method).

    Results
    A total of 67 patients were enrolled with median age of 70 (49-81). GOLD classification showed normal (n=32), mild (stage I/II, n=30), and moderate (stage III, n=5) airflow obstructions. There was no severe COPD (stage IV) patient. In GOLD classification, no-significant associations of clinical characteristics were observed such as lobe site of primary lesion (p=0.84), tumor histology (p=0.21), gender (p=0.17), and cigarette smoking (p=0.42). Goddard classification showed non (score zero, n=12), mild (score <8, n=32), and moderate-severe (score 8-20, n=23) emphysema findings. In Goddard classification, there were significant associations of clinical characteristics in tumor histology of squamous cell carcinoma (p=0.010), male (p=0.031), and number of cigarette smoking (p=0.020). Univariate analyses showed neither GOLD nor Goddard classification was associated with overall survival. In multivariate analysis, FEV/FVC% was not associated with overall survival.

    Conclusion
    As compared with Goddard classification, the distribution of GOLD classification shift relatively mild direction. Therefore, there is no-significant association of clinical characteristics in GOLD classification, and Goddard classification was significant association of squamous cell carcinoma, male, and cigarette smoking. Surprisingly, the FEV/FVC% did not become a prognostic factor for NSCLC received chemotherapy. The severity of COPD might not influence outcome of chemotherapy in advanced NSCLC.