Introduction Central airway obstruction (CAO) is a life-threatening complication of lung cancer. The prevalence of CAO in lung cancer patients is unknown. We audited CAO burden to inform our local cancer service.Methods This is a cohort review of all new lung cancer diagnoses between 1 November 2014 and 30 November 2015. CAO was defined by CT appearance. CT scans and routine patient records were followed up to 30 November 2018 to determine the prevalence of CAO at diagnosis; the characteristics of patients with prevalent CAO; mortality (using survival analysis); and incident CAO over follow-up.Results Of 342 new lung cancer diagnoses, CAO prevalence was 13% (95% CI 10% to 17%; n=45/342). Dedicated CT scan review identified missed CAO in 14/45 (31%) cases. In patients with prevalent CAO, 27/44 (61%) had a performance status of ≤2, 23/45 (51%) were diagnosed during an acute admission and 36/44 (82%) reported symptoms. Treatments were offered to 32/45 (71%); therapeutic bronchoscopy was performed in only 8/31 (26%) eligible patients. Median survival of patients with prevalent CAO was 94 (IQR 33–274) days. Multivariate analysis, adjusting for age, gender and disease stage, found CAO on index CT scan was independently associated with an increased hazard of death (adjusted HR 1.78 (95% CI 1.27 to 2.48); p=0.001). In total, 15/297 (5%) developed CAO during follow-up (median onset 340 (IQR 114–551) days). Over the audit period, 60/342 (18%; 95%?CI 14% to 22%) had or developed CAO.Discussions This is the first description of CAO prevalence in 40 years. Patients with prevalent CAO had a higher mortality. Our data provide a benchmark for service planning.
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机译：简介中央气道阻塞（CAO）是威胁生命的肺癌并发症。肺癌患者中CAO的患病率尚不清楚。我们审核了CAO负担以告知我们当地的癌症服务。方法这是一项队列研究，回顾了2014年11月1日至2015年11月30日期间所有新诊断出的肺癌。随访至2018年11月30日的CT扫描和常规患者记录，以确定诊断时CAO的患病率;流行性CAO患者的特征;死亡率（使用生存分析）;结果：在342例新诊断的肺癌中，CAO患病率为13％（95％CI为10％至17％; n = 45/342）。专门的CT扫描检查发现14/45（31％）的病例中缺少CAO。在具有广泛CAO的患者中，有27/44（61％）的表现状态≤2，在急性入院期间被诊断为23/45（51％），有36/44（82％）的症状报告。提供治疗的比例为32/45（71％）;仅8/31（26％）名合格患者进行了治疗性支气管镜检查。普遍CAO患者的中位生存期为94（IQR 33–274）天。通过对年龄，性别和疾病阶段进行调整的多变量分析发现，在CT扫描上进行的CAO与死亡风险的增加独立相关（HR调整后为1.78（95％CI为1.27至2.48）; p = 0.001）。在随访期间（中位发病340天（IQR 114–551）），总共有15/297（5％）的患者发生了CAO。在审核期间，有60/342（18％; 95％CI为14％至22％）已经或形成了CAO。讨论这是40年来对CAO患病率的首次描述。患有CAO的患者死亡率较高。我们的数据为服务计划提供了基准。
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