D Herrero Rivera1, J M Nieto-Guerrero Gómez2, J Cacicedo Fernández de Bobadilla3, D Delgado2, E Rivin Del Campo4, J M Praena-Fernández5, R Bernabé Caro1, M J Ortiz Gordillo2,6, M C Fernández Fernández2, J L Lopez Guerra7,8. 1. Department of Medical Oncology, University Hospital Virgen del Rocío, Seville, Spain. 2. Department of Radiation Oncology, University Hospital Virgen del Rocío, Manuel Siurot Avenue, s/n, 41013, Seville, Spain. 3. Department of Radiation Oncology, Cruces University Hospital, Barakaldo, Spain. 4. Department of Radiation Oncology, Tenon University Hospital, Paris, France. 5. Methodology Unit, University Hospital Virgen del Rocío, Seville, Spain. 6. Instituto de Biomedicina de Sevilla (IBIS/HUVR, CSIC/Universidad de Sevilla), Seville, Spain. 7. Department of Radiation Oncology, University Hospital Virgen del Rocío, Manuel Siurot Avenue, s/n, 41013, Seville, Spain. chanodetriana@yahoo.es. 8. Instituto de Biomedicina de Sevilla (IBIS/HUVR, CSIC/Universidad de Sevilla), Seville, Spain. chanodetriana@yahoo.es.
Abstract
PURPOSE: Chronic inflammation contributes to cancer development via multiple mechanisms. We hypothesized that cardiovascular diseases (CVD) are also an independent risk factor for survival in non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Prospective multicenter data from 345 consecutive NSCLC patients treated from January 2013 to January 2017 were assessed. Median follow-up for all patients was 13 months (range 3-60 months). There were 109 patients with baseline heart disease (HD 32%), 149 with arterial hypertension (43%), 85 with diabetes mellitus (25%), 129 with hyperlipidemia (37%) and 45 with venous thromboembolism events (VTE 13%). A total of 289 patients (84%) were treated with platinum-based chemotherapy (CT), 300 patients (87%) received thoracic radiation therapy (RT; median radiation dose: 60 Gy [range 12-70]); and 50 (15%) patients underwent surgery. RESULTS: Our cohort consisted of 305 men (88%) and 40 (12%) women, with a median age of 67 years (range 31-88 years). Seventy percent had a Karnofsky performance status (KPS) ≥ 80. Multivariate analyses showed a lower OS and higher risk of distant metastasis in patients with advanced stages (p = 0.05 and p < 0.001, respectively) and HD (HR 1.43, p = 0.019; and HR 1.49, p = 0.025, respectively). Additionally, patients with VTE had lower local control (HR 1.84, p = 0.025), disease-free survival (HR 1.64, p = 0.020) and distant metastasis-free survival (HR 1.73, p = 0.025). CONCLUSIONS: HD and VTE are associated with a higher risk of mortality and distant metastasis in NSCLC patients. Chronic inflammation associated with CVDs could be an additional pathophysiologic factor in the development of distant metastasis.
PURPOSE:Chronic inflammation contributes to cancer development via multiple mechanisms. We hypothesized that cardiovascular diseases (CVD) are also an independent risk factor for survival in non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Prospective multicenter data from 345 consecutive NSCLCpatients treated from January 2013 to January 2017 were assessed. Median follow-up for all patients was 13 months (range 3-60 months). There were 109 patients with baseline heart disease (HD 32%), 149 with arterial hypertension (43%), 85 with diabetes mellitus (25%), 129 with hyperlipidemia (37%) and 45 with venous thromboembolism events (VTE 13%). A total of 289 patients (84%) were treated with platinum-based chemotherapy (CT), 300 patients (87%) received thoracic radiation therapy (RT; median radiation dose: 60 Gy [range 12-70]); and 50 (15%) patients underwent surgery. RESULTS: Our cohort consisted of 305 men (88%) and 40 (12%) women, with a median age of 67 years (range 31-88 years). Seventy percent had a Karnofsky performance status (KPS) ≥ 80. Multivariate analyses showed a lower OS and higher risk of distant metastasis in patients with advanced stages (p = 0.05 and p < 0.001, respectively) and HD (HR 1.43, p = 0.019; and HR 1.49, p = 0.025, respectively). Additionally, patients with VTE had lower local control (HR 1.84, p = 0.025), disease-free survival (HR 1.64, p = 0.020) and distant metastasis-free survival (HR 1.73, p = 0.025). CONCLUSIONS:HD and VTE are associated with a higher risk of mortality and distant metastasis in NSCLCpatients. Chronic inflammation associated with CVDs could be an additional pathophysiologic factor in the development of distant metastasis.
Authors: Jaidyn Muhandiramge; John R Zalcberg; G J van Londen; Erica T Warner; Prudence R Carr; Andrew Haydon; Suzanne G Orchard Journal: Curr Oncol Rep Date: 2022-07-07 Impact factor: 5.075