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, Xicheng District, Beijing, 100037, China.
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, Xicheng District, Beijing, 100037, China.
Clin Transl Oncol. 2024 Jun;26(6):1348-1356. doi: 10.1007/s12094-023-03359-3. Epub 2023 Dec 16.
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.
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.
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).
Comprehensive management of CVD comorbidities is of vital importance for the long-term prognosis of SCLC patients.
小细胞肺癌（SCLC）是一种极其恶性的肺癌亚型，因为它具有很高的转移潜力。SCLC 的心脏侵犯是一个严重的问题，可能导致全身栓塞或轨道阻塞。心血管合并症可能显著影响 SCLC 患者的生存和治疗决策，这引起了人们的极大关注。
我们连续招募了 2011 年 1 月至 2018 年 12 月期间来自中国 4 家癌症专科医院的 772 名小细胞肺癌（SCLC）患者。仅包括新诊断的原发性癌症住院患者。使用单变量和多变量调整 Cox 比例风险模型评估与死亡率相关的危险因素。计算死亡率的风险比（HR）和相应的 95%置信区间（95%CI）。
所有 SCLC 患者中心血管疾病（CVD）的患病率为 34.6%。对数秩分析显示，在所有 SCLC 患者中，CVD 患者与无 CVD 患者的中位生存时间（MST）存在统计学差异（9.0 个月 vs. 15.0 个月，P=0.005）和接受化疗的患者（12.0 个月 vs. 18.0 个月，P=0.048）。心包积液（HR 1.671，95%CI 1.082-2.580，P=0.021）和心力衰竭（HR 1.752，95%CI 1.290-2.379，P<0.001）是所有 SCLC 患者死亡的独立危险因素。静脉血栓栓塞症（VTE）与仅接受化疗（HR 5.558，95%CI 1.335-23.135，P=0.018）和放化疗（HR 3.057，95%CI 1.270-7.539，P=0.013）患者的预后较差相关。
CVD 合并症的综合管理对 SCLC 患者的长期预后至关重要。
