The DIAMORFOSIS (DIAgnosis and Management Of lung canceR and FibrOSIS) survey: international survey and call for consensus.


Journal

ERJ open research
ISSN: 2312-0541
Titre abrégé: ERJ Open Res
Pays: England
ID NLM: 101671641

Informations de publication

Date de publication:
Jan 2021
Historique:
received: 27 07 2020
accepted: 23 09 2020
entrez: 3 2 2021
pubmed: 4 2 2021
medline: 4 2 2021
Statut: epublish

Résumé

Currently there is major lack of agreement on the diagnostic and therapeutic management of patients with idiopathic pulmonary fibrosis (IPF) and lung cancer. Our aim was to identify variations in diagnostic and management strategies across different institutions and provide rationale for a consensus statement on this issue. This was a joint-survey by European Respiratory Society (ERS) Assemblies 8, 11 and 12. The survey consisted of 25 questions. Four hundred and ninety-four (n=494) physicians from 68 different countries and five continents responded to the survey. Ninety-four per cent of participants were pulmonologists, 1.8% thoracic surgeons and 1.9% oncologists; 97.7% were involved in multidisciplinary team approaches on diagnosis and management. Regular low-dose high-resolution computed tomography (HRCT) scan was used by 49.5% of the respondents to screen for lung cancer in IPF. Positron emission tomography (PET) scan and endobronchial ultrasound (EBUS) is performed by 60% and 88% to diagnose nodular lesions with mediastinal lymphadenopathy in patients with advanced and mild IPF, respectively. Eighty-three per cent of respondents continue anti-fibrotics following lung cancer diagnosis; safety precautions during surgical interventions including low tidal volume are applied by 67%. Stereotactic radiotherapy is used to treat patients with advanced IPF (diffusing capacity of the lung for carbon monoxide ( The diagnosis and management of IPF-lung cancer (LC) is heterogeneous with most respondents calling for a consensus statement.

Sections du résumé

BACKGROUND BACKGROUND
Currently there is major lack of agreement on the diagnostic and therapeutic management of patients with idiopathic pulmonary fibrosis (IPF) and lung cancer. Our aim was to identify variations in diagnostic and management strategies across different institutions and provide rationale for a consensus statement on this issue.
METHODS METHODS
This was a joint-survey by European Respiratory Society (ERS) Assemblies 8, 11 and 12. The survey consisted of 25 questions.
RESULTS RESULTS
Four hundred and ninety-four (n=494) physicians from 68 different countries and five continents responded to the survey. Ninety-four per cent of participants were pulmonologists, 1.8% thoracic surgeons and 1.9% oncologists; 97.7% were involved in multidisciplinary team approaches on diagnosis and management. Regular low-dose high-resolution computed tomography (HRCT) scan was used by 49.5% of the respondents to screen for lung cancer in IPF. Positron emission tomography (PET) scan and endobronchial ultrasound (EBUS) is performed by 60% and 88% to diagnose nodular lesions with mediastinal lymphadenopathy in patients with advanced and mild IPF, respectively. Eighty-three per cent of respondents continue anti-fibrotics following lung cancer diagnosis; safety precautions during surgical interventions including low tidal volume are applied by 67%. Stereotactic radiotherapy is used to treat patients with advanced IPF (diffusing capacity of the lung for carbon monoxide (
CONCLUSION CONCLUSIONS
The diagnosis and management of IPF-lung cancer (LC) is heterogeneous with most respondents calling for a consensus statement.

Identifiants

pubmed: 33532484
doi: 10.1183/23120541.00529-2020
pii: 00529-2020
pmc: PMC7837280
pii:
doi:

Types de publication

Journal Article

Langues

eng

Informations de copyright

Copyright ©ERS 2021.

Déclaration de conflit d'intérêts

Conflict of interest: A. Tzouvelekis has received travel grants and consultation fees from Boehringer Ingelheim and Hoffmann La Roche outside the submitted work. Conflict of interest: K. Antoniou has received travel grants and consultation fees from Boehringer Ingelheim and Hoffmann La Roche. Conflict of interest: M. Kreuter has nothing to disclose. Conflict of interest: M. Evison has nothing to disclose. Conflict of interest: T.G. Blum has nothing to disclose. Conflict of interest: V. Poletti has nothing to disclose. Conflict of interest: B. Grigoriu has nothing to disclose. Conflict of interest: C. Vancheri has received unrestricted grants, and speaker and advisory board fees from Boehringer Ingelheim and F. Hoffmann-La Roche Ltd. Conflict of interest: P. Spagnolo reports grants, personal fees and nonfinancial support from Roche, PPM Services and Boehringer-Ingelheim, and reports personal fees from Red X Pharma, Galapagos and Chiesi, outside of the submitted work. Conflict of interest: T. Karampitsakos has nothing to disclose. Conflict of interest: F. Bonella has received travel grants and consultation fees from Boehringer Ingelheim, Hoffmann La Roche, Galapalagos, Savara and BMS. Conflict of interest: A. Wells has received travel grants and consultation fees from Boehringer Ingelheim and Hoffmann La Roche. Conflict of interest: G. Raghu has nothing to disclose. Conflict of interest: M. Molina-Molina reports grants and payment for scientific advice for Roche, Boehringer Ingelheim, Esteve-Teijin, Chiesi, Pfizer, GSK and Galapagos. Conflict of interest: D. Culver has nothing to disclose. Conflict of interest: E. Bendstrup has nothing to disclose. Conflict of interest: N. Mogulkoc has nothing to disclose. Conflict of interest: S. Elia has nothing to disclose. Conflict of interest: J. Cadranel reports grants from BI, and personal fees for consultancy and experts boards from Roche and BI, outside the submitted work. Conflict of interest: D. Bouros reports grants, personal fees, nonfinancial support and other support from BI Hellas, and other support from Roche, outside the submitted work.

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Auteurs

Argyris Tzouvelekis (A)

Dept of Internal and Respiratory Medicine, Medical School University of Patras, Patras, Greece.

Katerina Antoniou (K)

Dept of Respiratory Medicine, University of Crete, Athens, Greece.

Michael Kreuter (M)

Center for Interstitial and Rare Lung Diseases, Pneumology, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
German Center for Lung Research, Heidelberg, Germany.

Matthew Evison (M)

Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.

Torsten G Blum (TG)

Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin, Germany.

Venerino Poletti (V)

Dept of Thoracic Diseases, G.B. Morgagni Hospital, Forlì, Italy.

Bogdan Grigoriu (B)

Service des Soins Intensifs et Urgences Oncologiques & Oncologie thoracique, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles, Brussels, Belgium.

Carlo Vancheri (C)

Regional Referral Centre for Rare Lung Diseases, AOU "Policlinico-Vittorio Emanuele" Dept of Clinical and Experimental Medicine, University of Catania, Catania, Italy.

Paolo Spagnolo (P)

Respiratory Disease Unit, Department of Cardiac Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy.

Theodoros Karampitsakos (T)

Dept of Internal and Respiratory Medicine, Medical School University of Patras, Patras, Greece.

Francesco Bonella (F)

Dept of Pneumology and Allergy, Ruhrlandklinik Medical Faculty, University of Duisburg-Essen, Essen, Germany.

Athol Wells (A)

Interstitial Lung Disease Unit, Dept of Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK.

Ganesh Raghu (G)

Center for Interstitial Lung Disease, University of Washington, Seattle, WA, USA.

Maria Molina-Molina (M)

Hospital Universitari de Bellvitge, L'Hospitalet de LLobregat, Barcelona, Spain.

Daniel A Culver (DA)

Cleveland Clinic, Respiratory Institute, Cleveland, OH, USA.

Elisabeth Bendstrup (E)

Center for Rare Lung Diseases, Dept of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark.

Nesrin Mogulkoc (N)

Dept of Pulmonology, Faculty of Medicine, Ege University, İzmir, Turkey.

Stefano Elia (S)

Thoracic Surgery Unit, Tor Vergata University, Rome, Italy.

Jacques Cadranel (J)

Service de Pneumologie, APHP, Hôpital Tenon and Sorbonne Université, Paris, France.

Demosthenes Bouros (D)

First Academic Dept of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Classifications MeSH