Locality of Lung Cancer in Patients With Combined Pulmonary Fibrosis and Emphysema

Abstract

SESSION TITLE: Lung Cancer SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: Combined pulmonary fibrosis and emphysema (CPFE) is characterized by upper lobe emphysema and lower lobe fibrosis. Both emphysema and pulmonary fibrosis are established risk factors for the development of lung cancer (LC). There is a single study to date which reports the location of LC lesions in relation to CPFE. (1) METHODS: Consecutive adult patients seen at our tertiary care referral center from 2000-2016 were reviewed for CPFE. 301 cases of CPFE were documented. In these cases we identified the location of lung cancer at presentation. RESULTS: CPFE patients were predominantly male (72%) and active or prior smokers (85%). The prevalence of lung cancer was 8.3 % (n=25). Non-small cell lung cancer was more common (84%, n=21) predominantly exhibiting squamous cell histology (52%, n= 13). The majority originated in the lower lobes (LL) (60%, n=15), 6 were located in the upper lobes, 2 were hilar, and 1 each were found in the lingula and right middle lobe. Of those with available CT for review, 81% (n=13/16) were peripherally located within 2cm of the pleural edge. . Of lesions originating in the lower lobes, equal numbers were found in areas of fibrosis or emphysema (29% each). CONCLUSIONS: We report one of the largest single center CPFE cohorts noting LC predominance in the lower lobe with a predilection for a peripheral location within 2cm of the pleural edge. Reference 1. Zhang M, Yoshizawa A, Kawakami S, Asaka S, Yamamoto H, Yasuo M, et al. The histological characteristics and clinical outcomes of lung cancer in patients with combined pulmonary fibrosis and emphysema. Cancer Med. 2016;5(10):2721-30. CLINICAL IMPLICATIONS: There is a significant proportion of patients who develop lung cancer in the setting of CPFE. We report the location for origination of lung cancer in this patient population. DISCLOSURE: The following authors have nothing to disclose: Faria Nasim, Teng Moua No Product/Research Disclosure Information