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Cardiovascular comorbidities and their prognostic value in small cell lung cancer patients with chemoradiotherapy

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Abstract

Background

Small cell lung cancer (SCLC) is an extremely malignant subtype of lung cancer because of its high potential for metastases. Cardiac invasion of SCLC is a serious concern that may lead to systemic embolism or tract obstruction. It has aroused much concern that cardiovascular comorbidities may significantly affect the survival of SCLC patients and their treatment decisions.

Methods

We consecutively recruited 772 small cell lung cancer (SCLC) patients between January 2011 and December 2018 from 4 cancer specialty hospitals in China. Only newly diagnosed primary cancer inpatients were included. Univariable and multivariable adjusted Cox proportional hazard models were conducted to evaluate the risk factors associated with mortality. Hazard ratios (HRs) for mortality and corresponding 95% confidence intervals (95% CIs) were calculated.

Results

The prevalence of cardiovascular diseases (CVDs) was 34.6% in all SCLC patients. Log-rank analysis presented statistically significant differences in median survival time (MST) between patients with CVD and without CVD in all SCLC patients (9.0 months vs. 15.0 months, P = 0.005) and patients with chemotherapy only (12.0 months vs. 18.0 months, P = 0.048). Pericardial effusion (HR 1.671, 95% CI 1.082–2.580, P = 0.021) and heart failure (HR 1.752, 95% CI 1.290–2.379, P < 0.001) were independent risk factors associated with mortality in all SCLC patients. VTE is related to poorer prognosis in patients with chemotherapy only (HR 5.558, 95% CI 1.335–23.135, P = 0.018) and chemoradiotherapy (HR 3.057, 95% CI 1.270–7.539, P = 0.013).

Conclusions

Comprehensive management of CVD comorbidities is of vital importance for the long-term prognosis of SCLC patients.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Abbreviations

CT:

Computed tomography

CVD:

Cardiovascular diseases

EGFR:

Epidermal growth factor receptor

MST:

Median survival time

NSCLC:

Non-small cell lung cancer 

SCLC:

Small cell lung cancer

VEGF:

Vascular endothelial growth factor

VHD:

Valvular heart disease

VTE:

Venous thrombus embolism

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Acknowledgements

We thank Yunnan Cancer Hospital, Jiangxi Cancer Hospital, Chongqing Cancer Hospital, and Yuncheng Central Hospital for their support in data collection.

Funding

No funding was received for conducting this study.

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Author notes

  1. Hanyang Liang and Tianjie Wang contributed equally to this work and share first authorship.

Authors and Affiliations

  1. State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, FuWai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 North Lishi Road, **cheng District, Bei**g, 100037, China

    Hanyang Liang, Tianjie Wang, Dong Liu, Hao Wang, Zhengqing Ba, Ying **ao, Yilu Liu, Jiansong Yuan & Weixian Yang

  2. Key Laboratory of Pulmonary Vascular Medicine, National Center for Cardiovascular Diseases, FuWai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 North Lishi Road, **cheng District, Bei**g, 100037, China

    Jiansong Yuan & Weixian Yang

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Contributions

(I) Conception and design: J Y and W Y. (II) Administrative support: H W, Z B, Y X, and Y L. (III) Provision of study materials or patients: D L. (IV) Collection and assembly of data: H L and T W. (V) Data analysis and interpretation: H L and T W. (VI) Manuscript writing: All authors. (VII) Final approval of manuscript: all authors.

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Correspondence to Jiansong Yuan or Weixian Yang.

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The authors have no competing interests to declare that are relevant to the content of this article.

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Ethics approval was granted from the ethics committee of Yuncheng Central Hospital (YXLL2022004). The study conformed to the provisions of the Declaration of Helsinki (as revised in 2013).

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Written informed consent was obtained from all the participants prior to enrollment in this study.

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Liang, H., Wang, T., Liu, D. et al. Cardiovascular comorbidities and their prognostic value in small cell lung cancer patients with chemoradiotherapy. Clin Transl Oncol 26, 1348–1356 (2024). https://doi.org/10.1007/s12094-023-03359-3

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