Comparison of survival of chronic obstructive pulmonary disease patients with or without a localized non-small cell lung cancer

• The main reason for inoperability in patients with localized NSCLC is chronic obstructive pulmonary disease (COPD).
• Patients with COPD have a high annual mortality rate.
• Despite the serious prognosis of COPD, a localized NSCLC diagnosis negatively affects survival in COPD patients.
• Stereotactic body radiotherapy should still be considered for COPD patients diagnosed with localized NSCLC.

ObjectivesChronic obstructive pulmonary disease (COPD) and non-small cell lung cancer (NSCLC) are often co-existing diseases with poor prognosis. The aim of this study was to compare survival in COPD patients with localized NSCLC treated with stereotactic body radiotherapy (NSCLC group) with COPD patients without a malignant diagnosis (non-malignant group).Materials and methodsThe NSCLC group was prospectively recorded at the Department of Oncology from 2007 to 2013. The non-malignant group was selected among patients referred to the Department of Respiratory Medicine from 2005 until 2011 suspected of thoracic malignancy but without the malignant diagnosis maintained.ResultsIn a propensity score matched comparison the median overall survival was 53 vs. 71 months in the NSCLC and non-malignant groups, respectively (p < 0.001). Subgroup analyses showed survival for patients with mild/moderate COPD was affected statistically significant with a higher mortality rate by a diagnosis of localized NSCLC with hazard ratio = 2.62 (95% CI: 1.47–4.68) while an insignificant higher mortality rate with hazard ratio = 1.22 (95% CI: 0.71–2.08) was found in patient with severe/very severe COPD.ConclusionDespite the serious prognosis of COPD, a localized NSCLC diagnosis negatively affects survival in COPD patients. However, stereotactic body radiotherapy should still be considered for COPD patients diagnosed with localized NSCLC.