Clinico-pathological Profile of Lung Cancer Patients in a Tertiary Care Hospital, India: A Prospective, Cross-sectional Study

Abstract

Background: Adenocarcinoma (ADC) is the commonest subtype of lung cancer, though a number of studies in India have observed squamous cell carcinoma (SCC) to be the commonest histology. Majority of Indian studies on clinico-pathological profile are retrospective and there is limited data on comparison of demographic, clinical, and radiological features among histological subgroups of lung cancer. Methods: Three-hundred and twelve consecutive confirmed cases of lung cancer diagnosed from December 2014 to January 2017 were enrolled prospectively. Data pertaining to the demographic, clinical, radiological, pathological, and molecular profile were analyzed. Results: Their mean age was 57.2 ± 10.8 years. Of all the lung cancer patients studied, 80.5% were males and 73.4% were smokers. Across all histological subtypes, the commonest symptom was cough (76.9%). Chest pain, hoarseness of voice, dysphagia, and neck veins engorgement were significantly higher in small cell lung carcinoma (SCLC) cases, while hemoptysis in SCC cases. The most common radiological finding was a mass lesion predominantly located, peripherally in cases with ADC and SCC lung, while centrally in SCLC. The most common site for distant metastasis was the bone (32.5%), followed by the liver, adrenal, brain, and other organs. ADC, SCC, and SCLC constituted 48.1, 32.1, and 14.4%, respectively. Incidence of epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) mutations in ADC patients were 26.5% and 7.8%, respectively, with a predilection for nonsmokers. The most common EGFR mutation was exon 19 deletions. Conclusions: Adenocarcinoma lung may now be replacing SCC as the commonest type of lung cancer in Northern India. The overall incidence of EGFR mutations in ADC patients was 26.5%, with exon 19 deletion being the most common mutation.