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Impact of hypertrophic pulmonary osteoarthropathy on patients with lung cancer

Authors Fang YH, Hsu CC, Hsieh MJ, Hung MS, Tsai YH, Lin YC

Received 13 April 2017

Accepted for publication 25 September 2017

Published 25 October 2017 Volume 2017:10 Pages 5173—5177

DOI https://doi.org/10.2147/OTT.S139558

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Geoffrey Pietersz

Yu-Hung Fang,1 Chien-Chin Hsu,2 Meng-Jer Hsieh,3,4 Ming-Szu Hung,1,5,6 Ying-Huang Tsai,1,3 Yu-Ching Lin1,4–6

1Department of Pulmonary and Critical Care Medicine, Division of Thoracic Oncology, Chang Gung Memorial Hospital, Puzi, 2Department of Nuclear Medicine, Chang Gung Memorial Hospital, Kaohsiung Branch, Kaohsiung, 3Department of Respiratory Therapy, College of Medicine, Chang Gung University, Guishan, 4Department of Pulmonary and Critical Care Medicine, Division of Pulmonary Infection and Critical Care Medicine, Chang Gung Memorial Hospital, 5Department of Respiratory Care, Chang Gung University of Science and Technology, Puzi, 6Department of Medicine, College of Medicine, Chang Gung University, Guishan, Taiwan, Republic of China

Purpose: Hypertrophic pulmonary osteoarthropathy (HPOA) is a rare disease that most commonly occurs secondary to lung cancer. However, the clinical significance of HPOA remains unclear. The aim of this study was to evaluate the impact of HPOA on patients with lung cancer in Taiwan.
Patients and methods: Data regarding lung cancer patients who demonstrated findings of HPOA on bone scintigraphy between 2010 and 2016 were retrospectively analyzed. Pathological confirmation of cases was conducted at Chiayi and Kaohsiung Chang Gang Memorial Hospital. Clinical characteristics, including gender, smoking status, histology subtype, clinical stage, and epidermal growth factor receptor (EGFR) status were investigated.
Results: We identified 69 lung cancer patients with typical HPOA findings on bone scintigraphy. Among them, 56 were male (81.2%) and 51 were ex-smokers or current smokers (73.9%). Adenocarcinoma was the most common histology subtype (n=42, 60.9%). Of 34 patients subjected to EGFR mutation analysis, only 4 (11.8%) had EGFR-tyrosine kinase inhibitor (EGFR-TKI)-sensitive mutations.
Conclusion: Male, smoking, and adenocarcinoma were the most common clinical characteristics of lung cancer patients with HPOA in our cohort. However, the proportion of EGFR-TKI-sensitive mutation cases was extremely low.

Keywords: EGFR, lung cancer, hypertrophic pulmonary osteoarthropathy, bone scintigraphy

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