Impact of COPD on one-year survival of patients with advanced stage lung cancer- a prospective cohort study

<bold>Introduction:</bold> There is sparse literature on how COPD affects the one-year survival of patients with advanced-stage lung cancer. This study aimed to compare the one-year survival of advanced lung cancer patients(stage 3B and 4) with and without COPD. <bold>Method:</bold> A prospective cohort study on 72 advanced lung cancer patients with COPD and 108 without COPD, recruited over 11 months, were followed up for a period of 1 year. The clinical, histological and functional profiles were recorded for both groups. The overall survival (OS) was recorded in days from the day of diagnosis of lung cancer till the end of the study period or death of the patient, whichever was earlier. <bold>Results:</bold> In the COPD group 36.11% of lung cancer patients died while the mortality in the non-COPD group was 31.48% at the end of one year. The mean OS was 280.7 days in lung cancer patients with COPD and 300.7 days without COPD. Analysis of the Kaplan-Meier curves showed no statistically significant difference in OS between patients with and without COPD. In the multivariate cox proportional hazard model adjusting for the most relevant variables, the adjusted hazard ratio was statistically significant for smoking status (P=0.004), dyspnoea grading by mMRC(2 and above) (P=0.004), performance status(ECOG 3 and above) (P=0.046) and lung cancer histology(adenocarcinoma) (P<0.001), but not for COPD status (P=0.075). <bold>Conclusion:</bold> COPD did not have an observable impact on the OS of advanced lung cancer patients, however various factors such as smoking habits, degree of breathlessness, performance status level and lung cancer histology were found to have a notable influence on OS at the 1 year mark.