Title: Profile of Female Lung Cancer at a Tertiary Care Hospital in Kashmir Valley

Authors: Isha Puri, Fir Afroz, Nazir Ahmad Khan, Shaqul Qamar, Asifa Andleeb, Paramjeet Puri, Gul Mohammad Bhat

 DOI: https://dx.doi.org/10.18535/jmscr/v8i6.64

Abstract

Purpose: To analyze the clinicopathological characteristics and the outcome of various treatment modalities used in management of lung cancer in females.

Methods: This was a retro-prospective study in which female patients with histological confirmed lung cancer who were registered at Regional Cancer Centre of Sher-i-Kashmir Institute of Medical Sciences, Srinagar between 2008 to 2014 were enrolled. Patient characteristics with regard to age, clinical presentation, locality, investigations, pathological characters and outcome of various treatment modalities were studied in detail. Data was compared using Pearson chi-square and Fischer’s exact test. P value <0.05 was considered to be statistically significant. SPSS version 20 was used for analyzing the data.

Results: A total of 298 patients were enrolled and 167 received treatment. Most patients were in the elderly age group (32.9%) and were from Srinagar district (29.9%). Dry cough was present in 71.4% of patients at presentation. Most common diagnostic modality used was bronchoscopy (58.05%). Squamous cell ca was most common histology (41.5%). Most (63.4%) patients were non smokers. 54.4% of patients had stage 4 at presentation. Chemotherapy alone was the most frequently used treatment modality (33.5%). Only 96 were available for response evaluation. During follow up, 3.12% had local failure and 27.08% had distant metastasis. Overall 1,2,3 and 6 year survival rates were 72.2%, 21.9%, 4.5% and 1.3% respectively. Triple modality treatment had highest survival rates followed by chemoradiation.

Conclusion: Delayed diagnosis and advanced disease were responsible for poor outcome. Early diagnosis and treatment and combined modality of treatment can improve survival.

References

  1. Banker DD. J Postgrad Med. 1955;1:108. (cited by  Nagrath SP, Hazra DK, Lahiri B, Kishore B, Kumar P Primary carcinoma of the lung Clinicopathologic study of 35 cases Indian J Chest Dis 1970;12:15-24)
  2. Magarth I, Litak J. Cancer in developing countries:opportunity and challenge. J Natl Cancer Inst 1993; 85: 862-74.
  3. Jemal A, Thomas A, Murray T, Thun M. Cancer statistics,2002. CA Cancer J Clin 2002; 52: 23-47.
  4. Nanda Kumar A. Consolidated report of the population based cancer registries, incidence and distribution of cancer,1990-1996. National Cancer Registry Programme. New Delhi: Indian Council of Medical Research. 2001.
  5. Oncologist approved cancer information from American Society of clinical oncology-women and lung ca.
  6. Mghfoor I, Michael C Perry. Lung cancer. Ann Saudi Med 2005; 25: 1-12.
  7. Montain CF. A new international staging system for lung cancer. Chest 1986; 89 (suppl.): 225-33.
  8. Overholt RH, Neptune WB, Ashraf MM. Primary cancer of lung: a 42-year-experience. Ann Thorac Surg 1975; 20: 511-9.
  9. Bal S. Screening for lung cancer. Hospital Today 2001; 6: 609-11.
  10. Sheema Sheikh, Azra Shah1, Aijaz Arshed, Romana Makhdoomi, Rais Ahmad Histological Pattern of Primary Malignant Lung Tumours Diagnosed in a Tertiary Care Hospital: 10 Year Study Asian Pacific J Cancer Prev, 11, 1341-1346.
  11. Bhattacharyya Sujit Kumar, Mandal Abhijit, Deoghuria Debasis, AgarwalaAbinash, Aloke Gopal Ghoshal and Dey Subir Kumar ,Clinico-pathological profile of lung cancer in a tertiary medical centre in India,Analysis of 266 cases ,Journal of Dentistry and Oral Hygiene Vol. 3(3), pp. 30-33, March 2011.
  12. Jagdish Rawat, Girish Sindhwani, Dushyant Gaur, Ruchi Dua, Sunil Saini, Clinico-pathological profile of lung cancer in Uttarakhand, Indian Chest Society   Year : 2009,  Volume : 2,  Issue |  Page : 74-76.
  13. Parvaiz A. Koul, Satish Kumar Kaul, Mohammad Mushtaq Sheikh, Reyaz A. Tasleem,1 and Azra Shah2 Lung cancer in the Kashmir valley Lung India. 2010 Jul-Sep; 27(3): 131–137.
  14. Noronha V, Dikshit R, Raut N, Joshi A, Pramesh CS, George K, Agarwal JP, Munshi A, Prabhash K,the epidemiological patterns and clinical profile of lung cancer in India, Indian J Cancer. 2012 Jan-Mar;49(1):74-81.
  15. Sanjeet Kumar Mandal, Thaudem Tomcha Singh, Takhenchangbam Dhaneshor Sharma, Venkatesan Amrithalingam Clinico-pathology of Lung Cancer in a Regional Cancer Center in Northeastern India Asian Pac J Cancer Prev, 14 (12), 7277-7281.
  16. Khan NA, Afroz F, Lone MM, Teli MA, Muzaffar M, Jan N. Profile of lung cancer in Kashmir, India: a five-year study,Indian J Chest Disease Allied Sci 2006;48:187-190.
  17. Viswanath Sundaram, Nirlipta Sanyal Clinicopathological profile of bronchogenic carcinoma in a tertiary care hospital in eastern part of India Clin Cancer Investig J 2014;3:220-4 Year : 2014  |  Volume : 3  |  Issue : 3  |  Page : 220-224 .
  18. Shilpen Patel, Janelle Pakish, Philemon Yen, Tony Quang, Laurie Carr, Douglas Wood, Keith Eaton, Michael Mulligan, Renato Martins; Evaluation of Failure Patterns Using Trimodality in Non-Small Cell Lung Cancer; World J Oncol 2011; 2(2): 64-69.

Corresponding Author

Dr Isha Puri

Registrar Department of Radiation Oncology, Government Medical College Jammu, Pin-180001 (J&K) India