Clinico-pathological Profile of Lung Cancer at AIIMS: A Changing Paradigm in India

Background: Lung cancer is one of the commonest and most lethal cancers throughout the world. Theepidemiological and pathological profile varies among different ethnicities and geographical regions. At presentadenocarcinoma is the commonest histological subtype of non-small cell lung cancer (NSCLC) in most of theWestern and Asian countries. However, in India squamous cell carcinoma has been reported as the commonesthistological type in most of the series. The aim of the study was to analyze the current clinico-pathological profileand survival of lung cancer at our centre. Materials and
Methods: We analyzed 434 pathologically confirmedlung cancer cases registered at our centre over a period of three years. They were evaluated for their clinicaland pathological profiles, treatment received and outcome. The available histology slides were reviewed by anindependent reviewer.
Results: Median age was 55 years with a male:female ratio of 4.6:1. Some 68% of patientswere smokers. There were 85.3% NSCLC and 14.7% SCLC cases. Among NSCLCs, adenocarcinoma was thecommonest histological subtype after the pathology review. Among NSCLC, 56.8% cases were of stage IV whileamong SCLC 71.8% cases had extensive stage disease. Some 29% of patients did not receive any anticancertreatment. The median overall and progression free survivals of the patients who received treatment were12.8 and 7.8 months for NSCLC and 9.1 and 6.8 months for SCLC.
Conclusions: This analysis suggests thatadenocarcinoma may now be the commonest histological subtype also in India, provided a careful pathologicalreview is done. Most of the patients present at advanced stage and outcome remains poor.