Clinical characteristics of hospitalized lung cancer patients with concomitant idiopathic pulmonary fibrosis: a retrospective cohort study.

Background: Lung cancer (LC) is a common and lethal comorbidity of idiopathic pulmonary fibrosis (IPF). Concomitant IPF severely interferes with the management of LC, increasing the risk for complications of LC treatments. This study aimed to investigate real-world data of LC patients with concomitant IPF (LC-IPF). Methods: A retrospective analysis was conducted on the characteristics of hospitalized LC-IPF patients from 2014 to 2021. In total, 92 patients with a mean age of 68 years were diagnosed with LC-IPF after a detailed review of medical records. Results: There were 87 males and five females. The average age at the diagnosis of LC was 67.99±7.51 years. Eighty-two patients had a history of smoking. There were signs of emphysema in 69 patients. IPF was diagnosed before LC in 27 patients and simultaneously diagnosed with LC in 65 patients. After an IPF diagnosis, only six patients were prescribed antifibrotics. Most LC-IPF patients in the study had late-stage LC. Surgery was performed in 18 patients. Nonsurgical treatment for LC included chemotherapy (70 cases), immunotherapy (20 cases), targeted therapy (14 cases), radiotherapy (11 cases), and percutaneous ablation (7 cases). Thirty-one LC-IPF patients died during follow-up. Adenocarcinoma and surgical resection of the tumor were independent favorable prognostic factors for overall survival in this LC-IPF cohort. Conclusions: Most LC-IPF patients in this study were older males who had a history of smoking and presented with emphysema. Underdiagnosis of IPF was not uncommon, and a substantial portion of the IPF patients were not treated with antifibrotic drugs. Chemotherapy was the most common LC treatment. Adenocarcinoma and surgical resection of the tumor were independent favorable prognostic factors.