Analysis of symptoms and case history data in the set of 353 patients with lung cancer in 1st Pulmonary department of Charles University, Prague
Authors:
M. Marel 1; F. Krejbich 1; P. Stránská 1; O. Měřička 1; J. Homolka 1; Z. Skácel 1; M. Zemanová 2
Authors‘ workplace:
Univerzita Karlova v Praze, 1. lékařská fakulta, I. klinika TRN VFN
1; Univerzita Karlova v Praze, 1. lékařská fakulta, Onkologická klinika VFN
2
Published in:
Čas. Lék. čes. 2009; 148: 416-423
Category:
Original Article
Overview
Background.
Lung cancer (LC) incidence in men in the Czech Republic has been declining since 1995, in women it grows up continually. To analyse the characteristics of recent set of patients (pts) and contribution of their symptoms for diagnostic, treatment and prognosis we carried on the retrospective study on patients from 1st Pulmonary department from 2004-2007.
Methods and results. Men :
women ratio in the set of 353 pts was 2 : 1. The frequency of symptoms at the time of diagnosis were: cough 69%, dyspnoe 54%, loss of weight 49%, expectoration 39%, pain on the chest 37%, haemoptysis 17.7%, fever 16%, vena cava superior syndrome 3,7%. Smokers fell in to the disease in significantly younger age than nonsmokers, 63 vs. 73 years. 40% of pts with LC suffer from COPD, more frequently have had squamous type of cancer. 78% of the set was morphologically verified, most frequent types of cancer were squamous type (22.1%) followed by adenocarcinoma, 21.2%. Surgical therapy underwent 18.1% of the whole set.
We look consequently for correlation between symptoms and other data of the pts. The pts with abuse of alcohol beverage fell in to the disease in a younger age. The pts with central tumor suffer from stronger cough more frequently, at bronchoscopy had more often direct tumor changes. The pts with IV. TNM stage of LC more frequently suffer from fever and pain. Significantly fewer pts with dyspnoe, loss of weight and lower FEV1 underwent surgical resection. FEV1 was lower in pts with central than with peripheral type of tumor. In pts with direct bronchoscopical tumor changes were found more frequently haemoptysis, broader spectrum of symptoms, lower FVC and FEV1. Dyspnoe correlated with PaO2 but not with PaCO2. CRP was lower in pts with peripheral type of LC, higher in pts with small cell LC (SCLC). Occurrence of haemoptysis did not correlate with number of smoked cigarettes.
Conclusions.
In conclusion we proofed that proper taking of history case may accelerate and improve the diagnostic process.
Key words:
lung cancer, symptoms, diagnostic.
Sources
1. Marel M, Kalina P, Melínová L, et al. Epidemiological studies on lung cancer in the Bohemia region. Lung Cancer 1994; 10: 325–331.
2. Pezzotto SM, Mahuad R, Bay ML, et al. Variation in smoking-related lung cancer risk factors by cell type among men in Argentina: a case – control study. Cancer-Causes-Control, 1993; 4: 213–217.
3. Tong L, Spitz MR, Fueger JJ, et al. Lung carcinoma in former smokers. Cancer 1996; 78: 1004–1010.
4. Grivaux M, Breton P, Bombardon P, et al. Lung cancer among women in France. Lung Cancer 2004; 45: 279–287.
5. Koyi H, et al. A prospective study of total material of lung cancer from a county in Sweden 1997–1999: gender, symptoms, type, stage and smoking habits. Lung Cancer 2002; 36: 9–14.
6. Hrnčiarik M, Illichová E, Salajka F. Bronchogenní karcinom – souhrnný přehled pacientů léčených na Plicní klinice FN Hradec Králové v letech 2004–2005, Novinky v pneumologii. Sborník prací XIII kongresu ČPFS a SPFS, 2006; 132–133.
7. Tammemagi CM, Neslund-Dudas M, Simoff M, Kvale P. Impact of comorbidity on lung cancer survival. Int J Cancer 2003; 103: 792–802.
8. Buccheri G, Ferrigno D. Familial and personal history of cancer in bronchogenic carcinoma – frequency and clinical implications. Acta Oncol 2004; 43: 65–72.
9. Brock MV, Albert CM, Hooker A, et al. Risk of subsequent primary neoplazma developing in lung cancer patiens with prior malignancies. J Thorac Cardiovasc Surg 2006; 127: 1119–1125.
10. Plicková K, Špiclem V, Pešek M, Mukenšnábl P. Analýza přežití pacientů operovaných pro bronchogenní karcinom v letech 1986–1997. Rozhl Chir 2003; 82: 293–299.
11. Skřičková J, Špelda S, Svobodník A, et al. A realistic view of the treatment of non-small cell lung cancer. Lung Cancer, Current Topic, Monduzzi Editore S.p.A, 2001; 167–172.
12. Skřičková J, Tomíšková, M, Babičková L, et al. Vývoj chirurgické léčby nemalobuněčného bronchogenního karcinomu v letech 2000–2003. Sborník abstrakt, Hradecké pneumologické dny 2004; 33–35.
13. Marel M, Melínová L, Štastný B, et al. The results of surgical treatment of non-small cell lung cancer at the Pneumological Clinic in Prague, Czech Republic 1985–1990. Lung Cancer 1994; 11: 293–298.
14. Marel M, Skácel Z, et al. Operační léčba bronchogenního karcinomu v letech 1970–2001. Čas Lék čes 2003; 142: 88–92.
15. Drings P, Vogt-Moykopf I. Thorax-tumoren. Berlin, Heidelberg: Springer Verlag 1991.
16. Islam SS, Schottenfeld D. Declining FEV1 and chronic productive cough in cigarette smokers: a 25.year prospective study of lung cancer incidence in Tecumseh. Michigan. Cancer Epidemiol Biomarkers Prev 1994; 3: 289–298.
17. Kvale PA. Chronic cough due to lung tumors. Chest 2006; 129: 147S–153S.
18. Ide S. Fever and survival with drug-treated non-small cell lung cancer. Kurume Med J 2001; 48: 9–14.
19. Scott RH, McMilan DC, Brown DJ, et al. A prospective study of the impact of weight loss and the systemic inflammatory response on quality of life in patiens with inoperable non-small cell lung cancer. Lung Cancer 2003; 40: 295–299.
20. Potter JD, McMichael AJ. Alcohol, beer and lung cancer – a meaningful relationship? Int J Epidemiol 1984; 13: 240–242
21. Hamilton W, Peters TJ, Round A, et al. What are the clinical features of lung cancer before the diagnosis is made? A population based case-control study. Torax 2005; 60: 1059–1065.
22. Tsoumakidou M, Chrysofakis GI, Tsiligiani G, et al. A prospective analysis of 184 hemoptysis cases: diagnostic impact of chest X- ray, computed tomography, bronchoscopy. Respiration 2006; 73: 808–814.
23. Okutan O, Kartaloglu A, IIvan A, et al. Does the primary Lung Cancer rate increase among females? Bull Cancer 2004; 91: E201–E210.
24. Hoffman AJ, Given A, von Eye, et al. Relationships among pain, fatique, insomnia and gender in persons with lung cancer. Oncol Nurs Forum 2007; 34: 785–792.
25. Reyes-Gibby CC, Spitz M, Wu X, et al. Cytokine genes and pain severity in lung cancer: exploring the influence of TNF-alpha-308 G/A, IL 6-174G/C and IL 8-251 T/A. Cancer Epidem Biomark Prev 2007; 16: 2745–2751.
26. Martinéz M, Aparicio Uj, Sanchis A, et al. Fiber bronchoscopy in lung cancer: relationship between radiology, endoscopy, histology and diagnostic value in a series of 1801 cases. Arch Bronconeumol 1994; 30: 291–296.
27. Pavlovska I, Danilovski D, Orovchanec T. et al. An epidemiologic study of some characteristic of lung cancer. Folia Med (Plovdiv) 2004; 46: 23–31.
28. Frank W, Loddenkemper R. Modern examination methods in pneumology. Versicherungsmedizin 1995; 47: 191–200.
29. Annema J, Veselic M, Rabe F. EUS quided FNA of centrally located lung tumors following a non-diagnostic bronchoscopy. Lung Cancer 2005; 48, 357–361.
30. Saka H, Oki M, Kitagawa Ch, et al. Ultrathin bronchoscope in the diagnosis of peripheral lung lesions. Chest 2006; 130 (Suppl.): 110S.
31. Aono H, Okamoto H, Kunikane A, et al. Transbronchial needle aspiration cytology of subcarinal lymph nodes for staging procedure in the diagnosis of lung cancer. Respirology 2006; 11: 782–785.
32. Papi A, Casoni G, Caramori I, et al. COPD increases the risk of squamous histological subtype in smokers who develope non-small cell lung cancer. Thorax 2004; 59: 679–681.
33. Moro D, Villemain JP, Brambilla C, et al. CEA, CIFRA21-1 and SCC in non-small cell lung cancer. Lung Cancer 1995; 13: 169–176.
34. Haapoja IS, Blendowski C. Superior vena cava syndrome. Semin Oncol Nurs 1999; 15: 183–189.
Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistArticle was published in
Journal of Czech Physicians
Most read in this issue
- Receiver Operating Characteristic analysis and the Cost – Benefit analysis in determination of the optimal cut-off point
- Subacute thyroiditis confused with dental problem
- Fractional exhaled nitric oxide and its correlation with bioptic results in chronic cough patients
- Reduction of stuttering through bronchodilatation with β2 sympathomimetic drug formoterol