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• 12837

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  P3.22 - Poster Session 3 - Epidemiology, Etiology (ID 168)

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

  • 12838

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    P3.22-001 - Incidence of lung cancer and pulmonary emphysema, a study of 708 autopsy cases from University Hospital Motol, Prague (ID 957)

    09:30 - 09:30  |  Author(s): L. Čapková
    • Abstract

    Background
    The incidence of lung cancer in the Czech Republic is high. It has reached 91/100 000 in men and 31/100 000 in women. The TNM stages I and II are diagnosed in less than 20% of all patients. Patients with COPD are at higher risk of lung cancer. How exactly emphysema affects the development of malignancy and how many patients with/without emphysema will suffer from lung cancer is unknown. Likewise, we do not know how many patients with existing lung cancer are diagnosed post-mortem and we have been interested in whether this group of patients shares any common features. Therefore, we decided to carry out an autopsy study which would provide answers to our questions.

    Methods
    We compared clinical data with autopsy findings in patients, both adults and children, from the largest hospital in the Czech Republic. During two studied years (2011-2013) we obtained complete sets of data on 708 patients.

    Results
    The studied group included 398 men and 310 women, with a median age of 71 years. Autopsies found a total of 55 lung cancer cases (7.8% of the set). Out of these, 24 (44%) tumours were diagnosed only by autopsy. In 40% of autopsy cases emphysema was proved along with a pulmonary malignancy. In the group of 24 patients with newly diagnosed lung cancer, emphysema was more common than in patients with a previously known tumour (50% vs. 32%).Patients with lung cancer discovered during autopsy died due to CHF in 8 cases, pneumonia in 6 cases, exacerbation of COPD in 2 cases, stroke in 2 cases, other tumours in 3 cases, and abdominal conditions in 3 cases. Emphysema during lifetime has been described less often than post-mortem (84 vs. 197 patients). The prevalence of autopsy proven emphysema was therefore 27.8%, the prevalence determined by clinical data was 11.8%. Lung cancer was diagnosed in one of every 10 patients with emphysema (20/197) and one in every 15 patients without emphysema (35/511).

    Conclusion
    The number of patients undiagnosed with lung cancer during their lifetime (44%) was higher than both literature data and our expectations. Studies carried out in the past accounted for 1 newly diagnosed lung cancer case per 80 autopsies, whereas in our group the ratio was 1:30 (Ošťádal, Studia pneumologica, 1994). On the other hand 27.8% cases with emphysema confirmed by autopsy corresponded with data in literature (15-65%; Thurlbeck, W. et Wright, J. L.: Chronic Airflow Obstruction) and results of similar previous studies which proved emphysema in 53% of autopsies on cases around the age of 70 years (Dalquen, P.: Incidence of Pulmonary Emphysema, and Study of 467 randomised autopsy cases 1, Beiträge zur Pathologie, 153, 4, 330-381). Our further results confirmed our clinical experience about the more frequent occurrence of lung cancer in patients with emphysema (1 in 10) compared with those without emphysema (1 in 15). "Supported by Projects (Ministry of Health) of conceptual development of research organization 00064203 (FN Motol, Prague, Czech Republic)."