COPD Associated with Poorer Survival in Patients With NSCLC

Researchers have found that the impact of pre-existing chronic obstructive pulmonary disease (COPD) in patients with non-small cell lung cancer (NSCLC), that COPD is associated with shorter survival and marked differences in early stages of lung cancer.

Among the 66,963 patients diagnosed with NSCLC, the 22,497 with pre-existing COPD had poorer median overall survival (192 days) compared with patients without comorbid disease (206 days) and an 11 percent higher risk of death.

Median survival decreased among patients with COPD for all stages. The elevated risk of death associated with pre-existing COPD decreased with each stage of NSCLC; stage 1 patients had a 39 percent increased risk of death, stage 2 patients a 20 percent higher risk, stage 3 a 9 percent higher risk, and stage 4 patients had a 4 percent higher risk.

Older age, gender, race, comorbidity score and tumor grade were all significantly associated with higher risk of mortality.

“One potential explanation for worse prognosis of lung cancer patients with COPD could be because of inadequate cancer treatments, poor pulmonary function and lower quality of life,” researchers said. “Studies have also shown that COPD was an important predisposing factor for the development of respiratory-related complications and poorer long-term survival outcomes.”

The researchers relied on data from the Surveillance, Epidemiology and End Results-Medicare database, focusing on patients aged 66 years and older with COPD who were diagnosed with NSCLC at any stage between 2006 and 2010, and those individuals who were continuously enrolled in Medicare parts A and B in the 12 months prior to diagnosis.

The researchers determined that those with chronic bronchitis had a more significant impact on time-to-death compared with emphysema for all stages of cancer.

The increased risk of death associated with chronic bronchitis compared with emphysema followed similar patterns seen among the COPD and non-COPD cohorts, with risk of death decreasing with each stage of NSCLC. Stage 1 patients had a 40 percent higher risk of death, stage 2 had a 28 percent higher risk, stage 3 a 10 percent higher risk, and stage 4 patients had a 6 percent higher risk.

Click here to read the full article on AJMC.