P1.01-057 Metastatic Lung Cancer at a Tertiary Cancer Centre in South India

Abstract

Nonsmall cell lung cancer (NSCLC) has varying epidemiological patterns in different countries and also in different regions of each country. In a country with a high prevalence of lung cancer such as India, regional variations in demography exist. We did a retrospective analysis of histologically confirmed metastatic NSCLC patients who presented to our Department of Medical Oncology between August 2012 and July 2014. The patients were interviewed regarding their history of smoking (never smokers, light smokers, and heavy smokers). Never smokers were defined as those who have smoked <100 bidi/cigarettes in their life until disease onset. Light smokers were defined as those who smoke <10–100 bidi/cigarette pack years. Heavy smokers were defined as those who smoke more than 100 bidi/ cigarette pack years until disease. All lung cancer biopsy specimens were histologically characterized by morphology and immunohistochemistry (IHC). A diagnosis of AC was made if IHC staining was positive for CK7, TTF1, and napsin A; similarly, SCC was diagnosed if CK5/6 and p63 staining was positive. After confirmation of the histology subtype, patients were confirmed to have metastatic disease after assessment with contrast-enhanced computerized tomography thorax, abdomen scan, and radiolabeled bone scan. Our study did not include the small cell lung cancer patients. The data were analyzed on SPSS version 22 (IBM) software. A total of 304 patients were analyzed. About 55.6% of the patients were in the age group of 41–60 years. About 79.6% of the patients were symptomatic for <6 months before presentation. About 63.5% of the patients were smokers presenting with a median age of 59 years whereas nonsmokers formed 36.51% of the patients presenting with a median age of 47 (P < 0.001). About 82.6% of the male patients and 4.1% of female patients were smokers. Equal number of all patients had adenocarcinoma (AC) and squamous cell carcinoma (SCC) histology. AC histology was more common in the nonsmoking group (62% of patients). SCC histology was seen in 54.3% of smokers. Metastasis to the contralateral lung and pleura was seen in 58.2% of patients. NSCLC presents at a young age. Smoking is a significant risk factor and it is common in the urban populations as in the rural areas. Both AC and SCC histologies presented in equal proportions.