Reversal of digital clubbing in surgically treated lung cancer patients

• Published in: Jornal brasileiro de pneumologia Vol. 34; no. 7; pp. 481 - 489
• Main Authors: Moreira, José da Silva, Hass, Marlene, Moreira, Ana Luiza Schneider, Fleck, James de Freitas, Camargo, José de Jesus Peixoto
• Format: Journal Article
• Language: Portuguese
• Published: Brazil 01.07.2008
• Subjects: Adult; Age Distribution; Aged; Carcinoma, Squamous Cell - radiotherapy; Carcinoma, Squamous Cell - surgery; Female; Humans; Lung Neoplasms - etiology; Lung Neoplasms - radiotherapy; Lung Neoplasms - surgery; Male; Middle Aged; Osteoarthropathy, Secondary Hypertrophic - radiotherapy; Osteoarthropathy, Secondary Hypertrophic - surgery; Postoperative Period; Preoperative Care; Sex Distribution; Smoking - adverse effects; Treatment Outcome
• ISSN: 1806-3756

To objectively evaluate the reversal of digital clubbing (DC) in a series of surgically treated lung cancer patients, and to review the literature on the subject. Sixty-one patients with non-small cell lung cancer--40 with and 21 without DC--were treated by pulmonary resection. Eleven (18%) received additional postoperative radiation therapy. Preoperatively, as well as on postoperative days 7, 18, and 90, the hyponychial angle (HA) and the distal phalangeal depth/interphalangeal depth (DPD/IPD) ratio were determined on profile shadow projections of the index fingers. A review of the literature on reversal of DC (1954-2007) was also performed. From the preoperative period to postoperative day 90, HA decreased from 200.5 +/- 5.0 masculine to 193.3 +/- 6.8 masculine (p < 0.001), and the DPD/IPD ratio decreased from 1.014 +/- 0.051 mm to 0.956 +/- 0.045 mm (p < 0.001) in the group of 40 patients with DC. The HA and the DPD/IPD ratio decreased in 33 (82.5%) but remained the same in 7 (1.7%), 6 with unfavorable evolution. In the 21 patients without DC, HA (184.5 +/- 5.5 masculine) and the DPD/IPD ratio (0.937 +/- 0.046 mm) remained unchanged after surgery. In the literature (1954-2007), we found 52 cases, 5 of which were lung cancer cases, in which reversal of DC, observed in several clinical conditions, was explicitly reported. In most lung cancer patients, DC resolves after effective surgical treatment of the tumor, as can occur in patients with other conditions.