Shortened Survival of Lung Cancer Patients Initially Presenting with Pulmonary Tuberculosis

Abstract

It has been reported that the incidence of lung cancer is higher in patients with pulmonary tuberculosis (TB). However, there is little information on the survival and clinical characteristics of these patients. We retrospectively reviewed the medical records of patients with coexisting pulmonary TB and lung cancer covering a period from 1988 to 1994. There were 31 such patients among a total of 3928 lung cancers diagnosed. Lung cancer patients had an increased risk of active pulmonary TB in comparison with the general population in Taiwan. Diabetes mellitus (DM) was found in 37.5% of patients who were diagnosed as having active pulmonary TB within 2 years before, or concurrent with, the diagnosis of lung cancer. However, none of the patients who had developed lung cancer before TB had a history of DM. Epidermoid carcinoma accounted for 64.5% of these cases. The patients who had developed active pulmonary TB before, or concurrently with, the diagnosis of lung cancer survived shorter than those who did not have pulmonary TB at diagnosis of lung cancer (P=0.007). Survival from diagnosis of pulmonary TB was longer in patients who developed the disease earlier than lung cancer (P=0.046). Survival from the time of diagnosis of lung cancer was significantly longer in patients who developed cancer earlier than active pulmonary TB (P=0.0048), those without DM (P=0.0132), those with an early tumor stage (P=0.002), and those given specific cancer treatment (P=0.0001). It is concluded that survival is shorter in lung cancer patients who present initially with active TB than in those who do not have TB.

Squamous Cell Lung Cancer in a Male with Pulmonary Tuberculosis

“…Patients with TB diagnosed before or together with lung cancer had worse prognosis than those with no TB at the diagnosis of lung cancer [9]. In contrast, in one retrospective review TB improved median survival especially in SCC (11.6 vs 8.8 months, p < 0.01) [10].…”

Latent TB infection in newly diagnosed lung cancer patients – A multicenter prospective observational study

“…It is interesting that lung cancer located in typical TB areas was an independent predictor for LTBI after adjustment for other factors, including the presence of old TB lesion on chest radiogram. A few studies evaluated the association between lung cancer location and previous TB disease, reporting that lung cancer tended to occur on the same side as previous TB infection [11,25]. By definition, LTBI should have no documented pulmonary lesions on image examination.…”

Co-existent extrapulmonary, extragenital tuberculosis and gynaecological tumours: a reminder to pathologists

“…4 Special care is required during histopathological evaluation as this entity independently and significantly adds to the post operative morbidity and mortality, more so after adjuvant chemotherapy or radiotherapy. 5 Sometimes preoperative imaging including 18 F-FDG PET mistakenly reports pelvic tubercular lymphadenitis as possible tumor metastasis. Hence pathologists should always stay open to this possibility.…”

“…Hence pathologists should always stay open to this possibility. 5 A high index of suspicion is needed in view of the HIV pandemic causing resurgence of tuberculosis especially in third world countries.…”