Association between COPD severity and clinical presentation in lung cancer patients: insights from a tertiary referral hospital

Abstract

Background and objectives. Lung cancer is a leading cause of cancer-related mortality worldwide, and COPD may have a significant impact on clinical presentation and overall health status. This study aimed to evaluate the association between COPD severity and the histological type, stage, and prognosis of lung cancer in patients treated at a tertiary referral hospital. Materials and methods. This prospective analytic cohort study included 52 adult lung cancer patients who underwent spirometry and were classified according to GOLD and A–B–E criteria at a tertiary hospital. Results. Among the participants, most patients were male (76.9%) and smokers (57.7%), with adenocarcinoma as the predominant histopathological subtype (44.2%). Most patients presented at advanced stages, had wild-type EGFR status (73.1%), received chemotherapy as the main treatment (73.1%), had progressive disease (38.5%) as the most frequent RECIST outcome, and had generally preserved performance status (61.5%). More severe COPD (GOLD stages 3–4) was significantly more prevalent among patients with advanced lung cancer (stage IV; p = 0.007). Group E demonstrated a predominance of adenocarcinoma and a higher proportion of advanced-stage disease. Performance status worsened with increasing COPD severity, and more severe GOLD stages tended to occur at a younger age. Conclusions. Lung cancer was frequently diagnosed at advanced stages, particularly among patients with more severe COPD. An integrated multidisciplinary approach involving pulmonologists and oncologists is essential to optimize treatment strategies and improve prognosis in patients with coexisting COPD and lung cancer.

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