Characteristics of lung cancer among patients with idiopathic pulmonary fibrosis and interstitial lung disease – analysis of institutional and population data

Joo Heung Yoon; Mehdi Nouraie; Xiaoping Chen; Richard H Zou; Jacobo Sellares; Kristen L Veraldi; Jared Chiarchiaro; Kathleen Lindell; David O Wilson; Naftali Kaminski; Timothy Burns; Humberto Trejo Bittar; Samuel Yousem; Kevin Gibson; Daniel J Kass

doi:10.1186/s12931-018-0899-4

Respiratory Research (Oct 2018)

Characteristics of lung cancer among patients with idiopathic pulmonary fibrosis and interstitial lung disease – analysis of institutional and population data

Joo Heung Yoon,
Mehdi Nouraie,
Xiaoping Chen,
Richard H Zou,
Jacobo Sellares,
Kristen L Veraldi,
Jared Chiarchiaro,
Kathleen Lindell,
David O Wilson,
Naftali Kaminski,
Timothy Burns,
Humberto Trejo Bittar,
Samuel Yousem,
Kevin Gibson,
Daniel J Kass

Affiliations

Joo Heung Yoon: Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease and Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh
Mehdi Nouraie: Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease and Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh
Xiaoping Chen: Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease and Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh
Richard H Zou: Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease and Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh
Jacobo Sellares: Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease and Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh
Kristen L Veraldi: Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease and Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh
Jared Chiarchiaro: Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease and Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh
Kathleen Lindell: Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease and Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh
David O Wilson: Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease and Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh
Naftali Kaminski: Section of Pulmonary, Critical Care and Sleep Medicine, Yale University
Timothy Burns: Division of Hematology and Oncology, University of Pittsburgh
Humberto Trejo Bittar: Department of Pathology, University of Pittsburgh
Samuel Yousem: Department of Pathology, University of Pittsburgh
Kevin Gibson: Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease and Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh
Daniel J Kass: Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease and Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh

DOI: https://doi.org/10.1186/s12931-018-0899-4
Journal volume & issue: Vol. 19, no. 1
pp. 1 – 10

Abstract

Read online

Abstract Background Lung Cancer is occasionally observed in patients with Idiopathic Pulmonary Fibrosis (IPF). We sought to describe the epidemiologic and clinical characteristics of lung cancer for patients with IPF and other interstitial lung disease (ILD) using institutional and statewide data registries. Methods We conducted a retrospective analysis of IPF and non-IPF ILD patients from the ILD center registry, to compare with lung cancer registries at the University of Pittsburgh as well as with population data of lung cancer obtained from Pennsylvania Department of Health between 2000 and 2015. Results Among 1108 IPF patients, 31 patients were identified with IPF and lung cancer. The age-adjusted standard incidence ratio of lung cancer was 3.34 (with IPF) and 2.3 (with non-IPF ILD) (between-group Hazard ratio = 1.4, p = 0.3). Lung cancer worsened the mortality of IPF (p < 0.001). Lung cancer with IPF had higher mortality compared to lung cancer in non-IPF ILD (Hazard ratio = 6.2, p = 0.001). Lung cancer among IPF was characterized by a predilection for lower lobes (63% vs. 26% in non-IPF lung cancer, p < 0.001) and by squamous cell histology (41% vs. 29%, p = 0.07). Increased incidence of lung cancer was observed among single lung transplant (SLT) recipients for IPF (13 out of 97, 13.4%), with increased mortality compared to SLT for IPF without lung cancer (p = 0.028) during observational period. Conclusions Lung cancer is approximately 3.34 times more frequently diagnosed in IPF patients compared to general population, and associated with worse prognosis compared with IPF without lung cancer, with squamous cell carcinoma and lower lobe predilection. The causality between non-smoking IPF patients and lung cancer is to be determined.

Published in Respiratory Research

ISSN: 1465-9921 (Print); 1465-993X (Online)
Publisher: BMC
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the respiratory system
Website: https://respiratory-research.biomedcentral.com/

About the journal

Abstract

Keywords