Naslov
The effect of emergency presentation on survival of lung cancer patients.

Autori
Jakopovic, Marko ; Bitar, Lela ; Markelic, Ivona ; Seiwerth, Fran ; Dzubur, Fedza ; Hecimovic, Ana ; Cucevic, Branka ; Mazuranic, Ivica ; Redzepi, Gzim ; Vukic Dugac, Andrea ; Jankovic Makek, Mateja ; Samarzija, Miroslav

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
2016 ASCO Annual Meeting

Mjesto i datum
Chicago (IL), Sjedinjene Američke Države, 02.06.2016

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
lung cancer, survival

Sažetak
Background: A significant proportion of lung cancer patients are diagnosed through emergency department (ED), which is usually associated with poorer prognosis. We investigated the assocation between diagnosis of lung cancer after presentation through emergency department due to symptoms associated to lung cancer. Methods: Medical charts of 1359 newly diagnosed lung cancer patients in years 2012 and 2013 from Department for Respiratory Diseases Jordanovac, University Hospital Centre Zagreb were examined. Survival was calculated for overall lung cancer population and according to histology subtypes. Results: The medical charts of 951 males and 407 females, mean age 64 years (males 64.5, females 62) were reviewed. 292 out od 1359 patients (21, 5%) were diagnosed with lung cancer after initial presentation through ED. The most common reasons for ED admissions were hemopytsis (in 31% of patients), pneumonia (16%), brain metastasis (15%), dyspnea (10%) and superior vena cava syndrome in 8% of patients. There were no differences in histology subptypes between two different routes of presentation (most common histology subtype was adenocarcinoma followed by squamous histology). Significantly higher proportion of patients diagnosed after initial diagnosis through ED were at presentation in stage IV (61 vs 44%, p < 0.0001), poorer performance status (ECOG 3-4 vs ECOG 0-1, p < 0.0001), significantly less patients underwent surgical resection (14 vs 5%, p < 0.0001) and radiotherapy (56 vs 73%, p < 0.0001). Median overall survival (mOS) was significantly lower in patients diagnosed through ED (6.0 vs 10.0 months, p < 0.0001). In patients with non-small cell lung cancer (NSCLC) results were similar (mOS 6.0 vs 10.0 months, p < 0.0001). In patients with small cell lung cancer (SCLC) mOS was also significantly worse (7.0 vs 9.0 months, p < 0.0001) in patients diagnosed through ED. Conclusions: Higher stage, reduced access to surgical resection and radiotherapy, and significantly lower overall survival regardless of histology subtypes among lung cancer patients who presents through emergency department, stress out the importance of earlier diagnosis of lung cancer patients so that initial presentation through emergancy department can be reduced.

Izvorni jezik
Engleski

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