Comorbidities and mortality risk among extensive-stage small-cell lung cancer patients in mainland China: impacts of hypertension, type 2 diabetes mellitus, and chronic hepatitis B virus infection

Abstract

The present study investigated the impact of major comorbidities, including hypertension, type 2 diabetes mellitus (T2DM), and chronic hepatitis B virus (HBV) infection, on the progression-free survival (PFS) and overall survival (OS) of extensive-stage small-cell lung cancer (ES-SCLC) patients in China. Patients having a pathologic diagnosis of ES-SCLC between 2009 and 2017 were enrolled and grouped according to their specific comorbidities. The PFS and OS for each group were evaluated using the Kaplan–Meier method and Cox proportional hazard models. In total, 632 patients were analyzed. The median PFS (mPFS) of these patients was 9 months [95% confidence interval (CI), 6–12 months]. The mPFS of patients without hypertension or T2DM was 9 months; conversely, it was significantly reduced for patients with hypertension [7 months ( P < 0.0001)] or T2DM [5 months ( P < 0.0001)]. However, mPFS was not significantly different between patients with and without HBV infection ( P = 0.2936). A similar trend was observed for OS as well. Further multivariate analyses showed that the OS of patients with hypertension [hazard ratio (HR), 1.344; 95% CI, 1.073–1.683; P = 0.010] or T2DM (HR, 1.455; 95% CI, 1.134–1.868; P = 0.003) was significantly shorter than that of patients without these comorbidities. Accordingly, mortality risk was the highest in patients with concurrent hypertension and T2DM (HR, 1.665; 95% CI, 1.037–2.672; P = 0.00058). Our study found that hypertension and T2DM may be associated with a worse prognosis in ES-SCLC patients. Considerable attention should be paid to the accompanying anti-comorbidity therapies available for patients with ES-SCLC.

Clinical characteristics and prognostic model for extensive‐stage small cell lung cancer: A retrospective study over an 8‐year period

“… 3 , 18 , 20 , 21 Patients with extensive‐stage SCLC were predominantly smokers (75%) and male (80.3%), and the most common initial symptoms were mainly cough (54%), dyspnea (10%), bone pain (10%), asymptomatic (12%), and paraneoplastic syndromes (11%). 22 The most common comorbidities were hypertension, diabetes mellitus, 23 and chronic obstructive pulmonary disease, 24 accounting for 33.7%, 19%, and 7% of cases, respectively. The most common extra‐thoracic metastatic organs were bone, liver, brain, and adrenal gland, at 36.3%, 24%, 7%, 16.3%, and 15.7%, respectively.…”

Risk factors for pulmonary embolism in lung cancer patients with lower limb deep venous thrombosis: a case-control study

“…Elevated blood pressure has been previously shown to influence thrombosis via hypercoagulability, low blood flow, and endothelial damage, which increases the risk of vascular wall damage, promoting or aggravating the formation of thrombus ( 10 - 12 ). Hypertension has been reported as a risk factor of VTE in patients with idiopathic pulmonary fibrosis ( 13 ), and is associated with a significantly reduced overall survival (OS) for patients with lung cancer ( 14 ). However, to the best of our knowledge, this current study is the first to investigate the relationship between chronic hypertension and PE in lung cancer.…”

Association Between Obesity and Cancer Mortality: An Internal Medicine Outpatient Clinic Perspective

“…They reported that the mean progression-free survival of patients without diabetes was 9 months, while it was significantly reduced for patients with diabetes (5 months (P < 0.0001)). They also reported that the overall survival of patients with diabetes was significantly shorter than that of patients without diabetes (HR: 1.455; 95% CI: 1.134 - 1.868; P = 0.003) [ 50 ]. Kelkar and colleagues investigated the association between diabetes and prostate cancer-specific mortality.…”