Abstract
Purpose
Primary lung cancer is one of the most common types of cancers. Comorbidity has been shown to be a negative prognostic factor in the overall lung cancer population. The significance of the individual comorbidities is less well known. The purpose of this paper is to investigate the effect of each comorbid disease groups on survival.
Methods
The analysis is based on all patients with NSCLC who were registered in 2009–2011, in total 10,378 patients. To estimate the effect of each comorbidity group on the survival, we fitted a Cox regression model for each comorbidity group adjusting for age, sex, resection, and stage.
Results
Patients with cardiovascular comorbidity have a 30 % higher death rate [HR 1.30 with 95 % CI (1.13; 1.49)] than patients without comorbidity. Patients with diabetes and patients with cerebrovascular disorders and COPD have a 20 % excess mortality than patients without comorbidity: [HR 1.19 with CI (1.02; 1.39) for diabetes, HR 1.18 with CI (1.05; 1.33) for cerebrovascular disorders, and HR 1.20 with CI (1.10; 1.39 for COPD)].
Conclusion
Our study shows the importance of cardiovascular disease in lung cancer. Diabetes, cerebrovascular disorders, and COPD also have a significant impact on survival of NSCLC patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Extermann M (2007) Interaction between comorbidity and cancer. Cancer Control 14(1):13–22
Firat S, Byhardt RW, Gore E (2010) The effects of comorbidity and age on RTOG study enrollment in stage III non-small cell lung cancer patients who are eligible for RTOG studies. Int J Radiat Oncol Biol Phys 78(5):1394–1399
de Cos JS, Miravet L, Abal J et al (2008) Lung cancer survival in Spain and prognostic factors: a prospective, multiregional study. Lung Cancer 59:246–254
Tammemagi CM, Neslund-Dudas C, Simoff M, Kvale P (2003) Impact of comorbidity on lung cancer survival. Int J Cancer 103:792–802
Lüchtenborg M, Jakobsen E, Krasnik M et al (2012) The effect of comorbidity on stage-specific survival in resected non-small cell lung cancer patients. Eur J Cancer 48(18):3386–3395
Janssen-Heijnen ML, Schipper RM, Razenberg PP et al (1998) Prevalence of co-morbidity in lung cancer patients and its relationship with treatment: a population-based study. Lung Cancer 21:105–113
Nalbantov G, Kietselaer, Vandecasteele K et al (2013) Cardiac comorbidity is an independent risk factor for radiation-induced lung toxicity in lung cancer patients. Radiother Oncol 109:100–106
Mishra PK, Pandey R, Shackcloth MJ et al (2009) Cardiac comorbidity is not a risk factor for mortality and morbidity following surgery for primary non-small cell lung cancer. Eur J Cardiothorac Surg 35:439–443
Hatlen P, Grønberg BH, Langhammer A et al (2011) Prolonged survival in patients with lung cancer with diabetes mellitus. J Thorac Oncol 6(11):1810–1817
Inala A, Kaplana A, Kucukoner M et al (2014) Is diabetes mellitus a negative prognostic factor for the treatment of advanced non-small-cell lung cancer? Rev Port Pneumol 20(2):62–68
Lopez-Encuentra A, Astudillo J, Cerezal J et al (2005) Prognostic value of chronic obstructive pulmonary disease in 2994 cases of lung cancer. Eur J Cardiothorac Surg 27:8–13
Deleuran T, Thomsen RW, Nørgaard M et al (2013) Comorbidity and survival of Danish lung cancer patients from 2000–2011: a population-based cohort study. Clin Epidemiol 5(Suppl 1):31–38
Grose D, Devereux G, Milroy R (2011) Comorbidity in lung cancer: important but neglected. A review of the current literature. Clin Lung Cancer 12(4):207–211
Jakobsen E, Green A, Iachina M et al (2013) Nationwide quality improvement in lung cancer care: the Danish Lung Cancer Registry. J Thorac Oncol. 8:1238–1247
Andersen TF, Madsen M, Jørgensen J et al (1999) The Danish National Hospital Register. A valuable source of data for modern health sciences. Dan Med Bull 46:263–268
Charlson ME, Pompei P, Ales KL et al (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383
Edwards BK, Noone A, Mariotto AB et al (2014) Annual Report to the Nation on the status of cancer, 1975–2010, featuring prevalence of comorbidity and impact on survival among persons with lung, colorectal, breast or prostate cancer. Cancer 120(9):1290–1314
Read WL, Tierney RM, Page NC et al (2004) Differential prognostic impact of comorbidity. J Clin Oncol 22:3099–3103
Birim Ö, Kappetein AP, Borgers AJJC (2005) Charlson comorbidity index as a predictor of long-term outcome after surgery for nonsmall cell lung cancer. Eur J Cadiothorac Surg 28:759–762
Asmis TR, Ding K, Seymour L et al (2008) Age and comorbidity as independent prognostic factors in the treatment of non-small-cell lung cancer: a review of National Cancer Institute of Canada Clinical Trials Group Trials. J Clin Oncol 26:54–59
Iachina M, Green A, Jakobsen E (2014) The direct and indirect impact of comorbidity on the survival of patients with non-small cell lung cancer: a combination of survival, staging and resection models with missing measurements in covariates. BMJ Open 4:e003846
Sekine Y, Behnia M, Fujisawa T (2002) Impact of COPD on pulmonary complications and on long-term survival of patients undergoing surgery for NSCLC. Lung Cancer 37:95–101
Rijke JM, Schouten LJ, Velde GPM et al (2004) Influence of age, comorbidity and performance status on the choice of treatment for patients with non-small cell lung cancer; results of a population-based study. Lung Cancer 46:233–245
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Iachina, M., Jakobsen, E., Møller, H. et al. The Effect of Different Comorbidities on Survival of Non-small Cells Lung Cancer Patients. Lung 193, 291–297 (2015). https://doi.org/10.1007/s00408-014-9675-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00408-014-9675-5