Cardiovascular Outcomes in the Patients With Primary Central Nervous System Lymphoma: A Multi-Registry Based Cohort Study of 4,038 Cases

2023

Preprint

Background With the advancements in detection and treatment, the survival rates of patients with pancreatic cancer have gradually increased. However, cardiovascular disease has become a common complication among tumor patients due to treatments. The mortality and risks of cardiovascular mortality in patients with pancreatic cancer remain unclear. Objectives This retrospective cohort study aimed to evaluate the mortality patterns and quantify cardiovascular mortality risk in patients with pancreatic cancer. Methods Data extracted from the US Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2018 were used to conduct this study. Patients aged 15 or older with a primary diagnosis of pancreatic cancer were included. The primary endpoint was the death of cardiovascular disease among pancreatic cancer patients. Standardized mortality ratios (SMRs) were compared with the general cancer population in the US. The Competing Risk model was used to assess the association between pancreatic cancer and cardiovascular disease. Results A total of 125,324 patients primarily diagnosed with pancreatic cancer were enrolled, with a median follow-up time of 4.0 (1.0–12.0) months. The mean age at diagnosis was 68.97 ± 12.88 years, and 62,271 (49.69%) were male. Overall, 2862 patients died of cardiovascular disease. The SMR of cardiovascular disease was 1.81 (1.74–1.88), and the highest SMR in the subtype of cardiovascular disease was atherosclerosis (2.69, 95%CI: 1.90–3.48). In the multivariable Competing Risk model, patients with older age at diagnosis and who underwent surgery were associated with higher risks of cardiovascular diseases. Conclusions Cardiovascular disease mortality among patients with pancreatic cancer is higher than that in the general cancer population in the US. Patients with pancreatic cancer at higher risk of cardiovascular disease need more attention.

Section: Discussionsupporting

confidence: 92%

Cardiovascular Mortality among Patients with Pancreatic Cancer: A Population-based Study

Liu

2023

Preprint

“…Data were obtained from the SEER database, an authoritative data system that covers about 30% of the population of the United States ( 12 ). Institutional review board approval was not required for publicly available information ( 13 , 14 ). Patients in the SEER database initially diagnosed with PCNSL from 2007 to 2016 were included.…”

Section: Methodsmentioning

confidence: 99%

Non-cancer-specific survival in patients with primary central nervous system lymphoma: A multi-center cohort study

Chi

Zhou²,

Luo³

et al. 2023

Front. Oncol.

Self Cite

ObjectiveThe study aimed to evaluate the non-cancer-specific death risk and identify the risk factors affecting the non-cancer-specific survival (NCSS) in patients with primary central nervous system lymphoma (PCNSL).MethodsThis multi-center cohort study included 2497 patients with PCNSL in the Surveillance, Epidemiology and End Results (SEER) database from 2007 to 2016, with a mean follow-up of 4.54 years. The non-cancer-specific death risk in patients with PCNSL and primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL) was evaluated using the proportion of deaths, standardized mortality ratio (SMR), and absolute excess risk (AER). Univariate and multivariate competing risk regression models were utilized to identify the risk factors of NCSS.ResultsPCNSL was the most frequent cause of death in PCNSL patients (75.03%). Non-cancer-specific causes constituted a non-negligible portion of death (20.61%). Compared with the general population, PCNSL patients had higher risks of death from cardiovascular disease (CVD) (SMR, 2.55; AER, 77.29), Alzheimer’s disease (SMR, 2.71; AER, 8.79), respiratory disease (SMR, 2.12; AER, 15.63), and other non-cancer-specific diseases (SMR, 4.12; AER, 83.12). Male sex, Black race, earlier year of diagnosis (2007–2011), being unmarried, and a lack of chemotherapy were risk factors for NCSS in patients with PCNSL and PCNS-DLBCL (all P < 0.05).ConclusionNon-cancer-specific causes were important competing causes of death in PCNSL patients. More attention is recommended to non-cancer-specific causes of death in the management of PCNSL patients.

“…More to the point, results from analyses that use population-level databases tend to be more generalizable and representative than those from single-center reports ( 24 ). Actually, sufficient incorporated samples are needed to guarantee the accuracy of nomograms, as demonstrated our recent publications ( 5 , 18 , 24 ). Notably, no competing-risk model has been established to evaluate the risk of CVD among patients with CRC so far.…”

Section: Discussionmentioning

confidence: 93%

“…In the past decade, cardiovascular death (CVD) has been regarded as one of the most common late complications of cancer therapy ( 4 , 5 ). Indeed, the introduction of novel chemotherapeutic or immunotherapeutic drugs has brought considerable survival benefits for patients with advanced tumors ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Outcomes in the Patients With Colorectal Cancer: A Multi-Registry-Based Cohort Study of 197,699 Cases in the Real World

Wang

Front. Cardiovasc. Med.

et al. 2022

PurposeWe aimed to investigate the mortality patterns and quantitatively assess the risks of cardiovascular death (CVD) in patients with colorectal cancer (CRC). We also established a competing-risk model to predict the probability of CVD for patients with CRC.Patients and MethodsPatients with CRC who diagnosed between 2007 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) database were included in the present study. The cumulative incidence function (CIF) was used for CVD and other causes of death, and Gray’s test was used to determine the subgroup difference in CIF. The Fine-Gray proportional subdistribution hazards model was used for identifying independent risk factors for CVD. A novel competing-risk model was established to evaluate the probability of CVD for patients with CRC. The performance of the nomogram was measured by concordance index (C-index), calibration curve, decision curve analysis (DCA), and risk stratification.ResultsAfter a median follow-up of 37.00 months, 79,455 deaths occurred, of whom 56,185 (70.71%) succumbed to CRC and 23,270 (29.29%) patients died due to non-CRC, among which CVD accounted for 9,702 (41.69%), being the major cause of non-cancer deaths. The 1-, 3-, and 5-year cumulative rates for CVD were 12.20, 24.25, and 30.51%, respectively. In multivariate analysis, age, race, marital status, tumor size, tumor stage, advanced stage, surgery, and chemotherapy were independent risk factors of CVD among patients with CRC. The nomogram was well calibrated and had good discriminative ability, with a c-index of 0.719 (95% CI, 0.738–0.742) in the training cohort and 0.719 (95% CI, 0.622–0.668) in the validation cohort. DCA demonstrated that nomogram produced more benefit within wide ranges of threshold probabilities for 1-, 3-, and 5-year CVD, respectively.ConclusionThis study was the first to analyze the CIF and risk factors for CVD among CRC based on a competing-risk model. We have also built the first 1-, 3-, and 5-year competing nomogram for predicting CVD. This nomogram had excellent performance and could help clinicians to provide individualized management in clinical practice.