1090 Digital clubbing (DC) has no practical implications in lung cancer (LC): Results of a large prospective study

Abstract

Old and consolidated experience indicate that digital clubbing (DC) may accompany lung cancer (and sometimes precede its clinical recognition). The presence of digital clubbing was prospectively recorded from a series of 561 consecutive patients with a new primary LC. Other variables (in all, more than one hundred) included data from personal life style, clinical history, physical examination, laboratory evaluation, plus radiological and pathologic tumour findings, and the subsequent clinical course. Clinical characteristics of patients with or without DC were compared statistically using the x-square test and other nonparametric tests, including the log rank test for survival differences. Fifty-two patients (90% of the sample) presented with a clinically recognisable DC; four of them had additional clinical and radiological evidence of pneumonic hypertrophic osteoarthropathy. Three of the 70 patients with small cell lung cancer had a DC syndrome, as compared with 28 of the 251 with squamous cell cancer and 8 of the 93 with adenocarcinomas. Patients with DC showed more frequently a limited disease (10 of the 62 patients in stage 1 vs 16 of the 186 in stage IV had DC) and tended to survive longer (median survival=9.52 vs 8 mo.). However, no difference between the two groups of patients was statistically significant.