PT - JOURNAL ARTICLE AU - John Farley AU - John Maclay AU - Conor Tweed AU - Paul Carroll AU - Robert Milroy TI - Attempting tissue diagnosis in performance status 3 and 4 lung cancer patients may not influence treatment or survival DP - 2013 Sep 01 TA - European Respiratory Journal PG - 4827 VI - 42 IP - Suppl 57 4099 - http://erj.ersjournals.com/content/42/Suppl_57/4827.short 4100 - http://erj.ersjournals.com/content/42/Suppl_57/4827.full SO - Eur Respir J2013 Sep 01; 42 AB - IntroductionAfter a radiological diagnosis of lung cancer, further investigation and treatment is influenced by the fitness of a patient, taking into account the risks and potential benefits. Tissue diagnosis is usually deemed essential prior to administration of radical radiotherapy and chemotherapy, but less so for palliative radiotherapy.Aims and objectivesTo determine if obtaining a tissue diagnosis altered management in patients with performance status (PS) 3 and 4.MethodsDetails of all patients with lung cancer diagnosed in North Glasgow between 2009-2011 were prospectively recorded at a multidisciplinary meeting. We subsequently investigated the relationships between PS and tissue diagnosis, treatment and survival.Results 1842 patients were diagnosed with lung cancer. PS was recorded in 92%. Overall, tissue diagnosis was achieved in 81% of patients. Tissue diagnosis was attempted in 97% of patients with PS 0. Treatment was influenced in 85% of these patients in that they underwent chemotherapy, surgery or radical radiotherapy. Tissue diagnosis was attempted in 62% and 33% of PS 3 and 4 respectively, with tissue diagnosis influencing treatment in 7% and 0%. There was no difference in survival in patients with PS of 3 or 4 that had tissue diagnosis attempted (median days (95%CI): tissue 42 (31-53) vs no tissue 37 (25-49)).ConclusionsDiagnostic tests were performed in a significant proportion of patients with PS 3 and 4 to establish a tissue diagnosis, but treatment was only influenced by this in a small minority. Attempting tissue diagnosis in these patients did not give any survival benefit.