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Yusup Subagio Sutanto



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    P1.11 - Screening and Early Detection (Not CME Accredited Session) (ID 943)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.11-09 - The Delay of Lung Cancer Diagnosis Due to Misdiagnosing as Pulmonary Tuberculosis (ID 12797)

      16:45 - 18:00  |  Author(s): Yusup Subagio Sutanto

      • Abstract
      • Slides

      Background

      Indonesia is a country with the second largest number of Tuberculosis (TB) cases in the world. Clinical symptom similarities of lung cancer to those of pulmonary TB can lead lung cancer patients to be diagnosed as pulmonary TB and receive Anti Tuberculosis Treatment (ATT) especially in TB endemic countries. The evaluation of ATT responses is often less stringent, resulting in delayed diagnosis of lung cancer. This study aimed to investigate the percentage of delayed lung cancer diagnosis due to misdiagnosing as pulmonary TB thus receiving ATT over one month.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A descriptive study was conducted in Dr. Moewardi Hospital, Solo Indonesia by using patients’ medical record data from January 2014 to February 2016.

      4c3880bb027f159e801041b1021e88e8 Result

      Of the 305 lung cancer patients, 194 (63.6%) were males and 111 (36.4%) were females and the average age was 48 years old. History taking and Acid Fast Bacillus (AFB) smear revealed 93 (30.5%) patients were diagnosed as pulmonary TB and received ATT. Three (1%) were found to have lung cancer in conjunction with pulmonary TB with positive AFB while 90 (29.5%) lung cancer patients had been misdiagnosed as pulmonary TB and had been given ATT with the average duration of 3.26 months and the longest administration was 7 months. Based on the duration of ATT there were 22 (24.4%) and 68 (75.6%) patients receiving ATT for ≤ 1 month and > 1 month respectively. Of the 90 lung cancer patients who had misdiagnosis as pulmonary TB, there were 56.7% males, 94.4% aged over 40 years old and 62.2% smokers. The types of lung cancer were non-small cell lung carcinoma (NSCLC) consisted of 68 (75.6%) adenocarcinoma, 13 (14.4%) squamous cell carcinoma, 5 (5.6%) large cell carcinoma, and 2 (2.2%) neuroendocrine carcinoma. Two (2.2%) of the patients were small cell lung cancer (SCLC). Based on NSCLC staging there were 0% stage I, 0% stage II, 0% stage IIIa, 11.1% IIIb and 88.9% stage IV. The most common metastasis was pleural effusion (58.9%) followed by other organ (27.8%).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Our study revealed that 29.5% lung cancer patients who were previously misdiagnosed as pulmonary TB, 75.6% of them received ATT over a month with the average duration of 3.26 months. This misdiagnosis resulted in the delay of lung cancer diagnosis.

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