Symptoms at lung cancer diagnosis are associated with major differences in prognosis

Thorax. 2018 Dec;73(12):1177-1181. doi: 10.1136/thoraxjnl-2018-211596. Epub 2018 Apr 17.

Abstract

We report a cohort study of survival of patients with lung cancer presenting to a single multidisciplinary team between 1997 and 2011, according to symptoms at presentation. The overall median survival of the 3800 lung cases was 183 days (95% CI 171 to 195). There was a statistically significant difference in survival between the 12 symptom groups identified both without and with adjustment for the prognostic variables of age, gender and histology (P<0.001). Compared with the cough-alone symptom group, the risks of dying or HRs were significantly higher for the groups presenting with breathlessness (HR 1.86, 95% CI 1.54 to 2.24, n=359), systemic symptoms (HR 1.91, 95% CI 1.48 to 2.45, n=95), weight loss (HR 2.46, 95% CI 1.90 to 3.18, n=106), chest pain (HR 1.96, 95% CI 1.56 to 2.45, n=159), cough with breathlessness (HR 1.59 95% CI 1.28 to 1.98, n=177), neurological symptoms (HR 3.07, 95% CI 2.45 to 3.84, n=155) and other symptom combinations (HR 2.05, 95% CI 1.75 to 2.40, n=1963). Cough may deserve particular prominence in public health campaigns.

Keywords: lung neoplasms; prognosis; symptoms.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / complications*
  • Carcinoma, Non-Small-Cell Lung / diagnosis
  • Chest Pain / etiology
  • Cough / etiology
  • Dyspnea / etiology
  • Female
  • Hemoptysis / etiology
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / complications*
  • Lung Neoplasms / diagnosis
  • Male
  • Middle Aged
  • Nervous System Diseases / etiology
  • Prognosis
  • Retrospective Studies
  • Small Cell Lung Carcinoma / complications*
  • Small Cell Lung Carcinoma / diagnosis
  • Survival Rate
  • Symptom Assessment*
  • Weight Loss