Effect of COPD on symptoms, quality of life and prognosis in patients with advanced non-small cell lung cancer

Abstract

BackgroundMany studies have reported the prevalence of chronic obstructive pulmonary disease (COPD) and its effects and prognosis in patients with lung cancer, but few have considered quality of life and survival of patients with lung cancer according to severity of airway obstruction. This study investigated the presence of COPD and the severity of airway obstruction in patients with non-small cell lung cancer (NSCLC), and analyzed how these factors affected symptoms, quality of life, and prognosis.MethodsWe retrospectively reviewed the prospective lung cancer database of the Catholic Medical Centers at the Catholic University of Korea from 2014 to 2017. We enrolled patients with advanced NSCLC and evaluated quality of life using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30. We also estimated pulmonary function and analyzed survival data.ResultsOf the 337 patients with advanced NSCLC, 170 (50.5%) had COPD and 167 (49.5%) did not. Significant differences were observed in symptoms between the two groups. The COPD group complained of more symptoms, such as cough, sputum, and dyspnea, than those in the non-COPD group. The distribution according to the severity of obstruction in the COPD group was as follows: Grade 1 (FEV1 ≥ 80%) 35 patients (20.6%), Grade 2 (50% ≤ FEV1 < 80%) 103 patients (60.6%), Grade 3 (30% ≤ FEV1 < 50%) 24 patients (14.1%), and Grade 4 (FEV1 < 30%) 8 patients (4.7%). The presence of COPD did not affect overall quality of life in patients with NSCLC, but as the airway obstruction increased, physical function decreased, and fatigue and dyspnea were more frequent. The overall median survival of the COPD group was shorter than that of the non-COPD group (median survival, 224 vs. 339 days, p = 0.035).ConclusionsIn this study, a high prevalence of COPD was found among patients with advanced NSCLC, and COPD patients complained about various symptoms and had diminished quality of life in several sectors. Therefore, it is necessary to actively evaluate quality of life, lung function, and symptoms in patients with lung cancer and reflect them in the treatment and management plans of these patients.

The prognosis of non‐small cell lung cancer combined with chronic obstructive pulmonary disease: A systematic review and meta‐analysis

“…At present, there are many reports on the impact of COPD on the prognosis of NSCLC, but opinions are not uniform. Maria Iachina et al showed that the survival rate of NSCLC patients with COPD significantly decreased, and Norihito Omote et al showed that mild to moderate COPD had no significant adverse effect on the prognosis of NSCLC patients . Our meta‐analysis showed that NSCLC with COPD had a poor prognosis, similar to the results of Maria Iachina et al Besides, Maria Iachina contributed significantly to the study, accounting for 67.9% (Fixed effect model), which seemed to be related to the large proportion of the total sample size included and the large proportion of the sample size of NSCLC without COPD.…”

“…The sample sizes for different studies of NSCLC ranged from 85 to 10 378, with a total number of 14 164, including COPD 2450 and Non‐COPD 9395. 12 case‐control studies were conducted in Korea, Denmark, Japan, the United States and Spain . In terms of diagnosis of COPD, 4 studies used Spirometry, 3 studies used GOLD guideline, 2 studies used American Thoracic Society criteria or European Respiratory Society criteria, 1 studies used Spirometry and/or Computed tomography (CT), 1 studies used Medical record and 1 studies used doctor‐diagnosis …”

Impact of smoking amount on clinicopathological features and survival in non-small cell lung cancer

“…The CMC lung cancer registry registered patients' symptoms, comorbid diseases, quality of life, and smoking history (smoking status, amounts, and cessation duration) through a same questionnaire at the time of lung cancer diagnosis (Supplementary 1). Smoking status was defined as our previous work [10,11]. Current smoker was defined a patient who continued smoking upon diagnosis or stopped smoking less than 1 month before diagnosis of lung cancer.…”

Smoking is associated with pneumonia development in lung cancer patients

“…We analyzed data of patients from Seoul St. Mary's Hospital and Bucheon St Mary's Hospital among cohort hospitals because their medical charts related to the development of pneumonia were available for review. The CMC lung cancer registry has registered patients' symptoms, quality of life, and accompanying diseases through a common questionnaire at the time of diagnosis [7]. We also collected smoking history including smoking status, pack-year, and duration of smoking cessation.…”