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Radiological Characteristics, Histological Features and Clinical Outcomes of Lung Cancer Patients with Coexistent Idiopathic Pulmonary Fibrosis

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Abstract

Introduction

Despite advances in diagnosis and management, the outcomes for both lung cancer and idiopathic pulmonary fibrosis (IPF) are still unfavourable. The pathophysiology and outcomes for patients with concomitant lung cancer and IPF remains unclear.

Methodology

A retrospective analysis was performed of all patients presenting with concomitant IPF and lung cancer to our centre over a 3-year period. Patients with connective tissue disease, asbestos exposure, sarcoidosis, previous thoracic radiation, radiological evidence of fibrosis but no histological confirmation of lung cancer, or the use of medications known to cause pulmonary fibrosis were excluded. We describe clinical, radiological and pathological characteristics of this group. We also report the response to standardized lung cancer therapy in this cohort.

Results

Of 637 lung cancer patients, 34 were identified with concomitant IPF (5.3 %) and all were smokers. 85 % had non-small cell lung cancer, 41 % were squamous cell cancers. The majority of tumours were located in the lower lobes, peripheral and present in an area of honeycombing. Despite the fact that approximately 2/3rds of the patients had localised or locally advanced lung cancer, the outcome of therapy for lung cancer was extremely poor regardless of tumour stage or severity of IPF.

Conclusions

At our centre, 1/20 patients with lung cancer have concomitant IPF. The majority of these tumours are small in size, peripheral in location and squamous cell carcinoma; in an area of honey combing. The outcome for concomitant lung cancer and IPF regardless of stage or therapy is poor.

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Conflict of interest

All the authors involved in the study confirm that there are no known conflicts of interest associated with this publication and there has been no financial support for this work that could have influenced its outcome.

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Authors and Affiliations

  1. The Department of Respiratory Medicine, Cork University Hospital, University College Cork, Wilton, Cork, Ireland

    K. A. Khan, M. P. Kennedy, E. Moore & M. T. Henry

  2. The Department of Radiology, Cork University Hospital, University College Cork, Cork, Ireland

    L. Crush & M. M. Maher

  3. The Department of Pathology, Cork University Hospital, University College Cork, Cork, Ireland

    S. Prendeville & L. Burke

Authors
  1. K. A. Khan
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  2. M. P. Kennedy
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  3. E. Moore
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  7. L. Burke
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  8. M. T. Henry
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Correspondence to K. A. Khan.

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Khan, K.A., Kennedy, M.P., Moore, E. et al. Radiological Characteristics, Histological Features and Clinical Outcomes of Lung Cancer Patients with Coexistent Idiopathic Pulmonary Fibrosis. Lung 193, 71–77 (2015). https://doi.org/10.1007/s00408-014-9664-8

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  • DOI: https://doi.org/10.1007/s00408-014-9664-8

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