ASSOCIATION WITH EMPHYSEMA ON COMPUTED TOMOGRAPHY AND LUNG CANCER IN SMOKERS

Background: Lung cancer is attributable largely to tobacco consumption. Also, several studies have explored the impact of emphysema as measured by chest computed tomography (CT) on the risk of lung cancer. Despite this strong association, only a minority of smokers develop emphysema or lung cancer. Objectives: To explore that distinguishes lung cancer with and without emphysema on CT in smokers. Methods: We reviewed retrospectively smoking patients with pathologically proved primary lung cancer. Emphysema was graded on CT by two readers, using a standardized rubric. Results: Six hundred and thirty-four out of 1113 lung cancer patients evaluated from January 2009 to May 2013. The mean age of the patients was 65 years and 579 (91.3%) patients were male. Three hundred and twelve (49.2%) patients had emphysema on CT chest. The most common histologies were squamous (245 (38.6%)), adenocarcinoma (206 (32.5%)), small cell carcinoma (120 (18.9%)) and others (63 (9.9%)). The non small cell lung cancer (NSCLC) patients with emphysema were more likely to have squamous histology (p=0.009) and early stage (I to IIIA) (p=0.033). Multivariate analysis revealed that old age, advanced stage and emphysema on CT were significant poor prognostic factors in 384 patients who were treated for lung cancer. Conclusion: In this study, NSCLC patients with the emphysema were more likely to have squamous histology and early stage, but showed significantly poor prognosis. References 1. Ueda K, et al. Clin Cancer Res 2006;12:6730-6736 2. Smith BM, et al. Lung cancer 2012;77:58-63.