Shortened Survival of Lung Cancer Patients Initially Presenting with Pulmonary Tuberculosis

It has been reported that the incidence of lung cancer is higherin patients with pulmonary tuberculosis (TB). However, thereis little information on the survival and clinical characteristicsof these patients. We retrospectively reviewed the medical recordsof patients with coexisting pulmonary TB and lung cancer coveringa period from 1988 to 1994. There were 31 such patients amonga total of 3928 lung cancers diagnosed. Lung cancer patientshad an increased risk of active pulmonary TB in comparison withthe general population in Taiwan. Diabetes mellitus (DM) wasfound in 37.5% of patients who were diagnosed as having activepulmonary TB within 2 years before, or concurrent with, thediagnosis of lung cancer. However, none of the patients whohad developed lung cancer before TB had a history of DM. Epidermoidcarcinoma accounted for 64.5% of these cases. The patients whohad developed active pulmonary TB before, or concurrently with,the diagnosis of lung cancer survived shorter than those whodid not have pulmonary TB at diagnosis of lung cancer (P = 0.007).Survival from diagnosis of pulmonary TB was longer in patientswho developed the disease earlier than lung cancer (P = 0.046).Survival from the time of diagnosis of lung cancer was significantlylonger in patients who developed cancer earlier than activepulmonary TB (P = 0.0048), those without DM (P = 0.0132), thosewith an early tumor stage (P = 0.002), and those given specificcancer treatment (P = 0.0001). It is concluded that survivalis shorter in lung cancer patients who present initially withactive TB than in those who do not have TB.