CLINICORADIOLOGICAL AND PATHOLOGICAL PROFILE OF PRIMARY LUNG CANCER PATIENTS: A STUDY FROM A TERTIARY CARE CENTRE IN RAJASTHAN

Abstract

Lung cancer remains one of the leading causes of cancer-related morbidity and mortality worldwide, with a rising burden in developing countries including India. Despite advances in diagnostics and therapeutics, most patients continue to present at advanced stages, contributing to poor survival outcomes. Understanding clinicoradiological and histopathological patterns is essential for improving diagnostic strategies and treatment planning.

Objectives: To assess the clinical, radiological, and pathological profile of primary lung cancer patients and evaluate the diagnostic yield of commonly used procedures.

Methods: This prospective, observational study was conducted in the Department of Respiratory Medicine at a tertiary care centre in Rajasthan from June to November 2025. A total of 100 clinically and radiologically suspected cases of primary lung cancer were evaluated and confirmed histopathologically. Demographic details, smoking history, clinical features, radiological findings, diagnostic procedures, and histological subtypes were recorded. Statistical analysis was performed using SPSS version 26, with p <0.05 considered significant.

Results: Most patients were male (84%) with a mean age of 58.5 years. A significant proportion (80%) were smokers, and 86.25% of them were heavy smokers (Smoking Index >300). The most common presenting symptom was cough (92%), followed by dyspnea (78%) and chest pain (75%). Radiologically, mass lesions were detected in all patients on CT scan, and hilar/mediastinal lymphadenopathy was seen in 94%. Bronchoscopy demonstrated the highest diagnostic yield for endobronchial biopsy (90.48%), followed by CT-guided FNAC (78.95%). Adenocarcinoma was the most common histological subtype (45%), followed by squamous cell carcinoma (36%) and small-cell carcinoma (16%). Advanced disease presentation was common, with 65.9% of non-small cell lung cancer cases staged as III/IV at diagnosis.

Conclusion: Primary lung cancer cases in this study exhibited a strong association with male gender, older age, and cigarette smoking. A shift toward adenocarcinoma as the most common subtype was noted, particularly among females and non-smokers. Most patients presented at an advanced stage, highlighting delays in diagnosis and the need for improved screening programs, better awareness, and accessible diagnostic pathways to enable earlier detection and improved outcomes.