Key result
Baseline AF linked to ~2.4-fold higher mortality in lung cancer patients.
Why the study?
Cardiovascular disease and cancer coexist and lead to exertional dyspnea, prompting evaluation of the prognostic value of cardiac comorbidities, ECG, and baseline echocardiography in lung cancer patients with reduced performance status.
Do baseline electrocardiographic and echocardiographic parameters predict overall survival in patients with advanced lung cancer?
Cohort (n=104)
No
Do baseline electrocardiographic and echocardiographic parameters predict overall survival in patients with advanced lung cancer?
Hazard Ratio: 2.39
Baseline ECG and echocardiographic parameters, particularly right ventricular metrics and atrial fibrillation, provide significant prognostic value for overall survival in patients with advanced lung cancer.
May inform prognosis in advanced lung cancer; hypothesis-generating and requires prospective validation before guiding interventions.
Cardiovascular disease and cancer coexist and lead to exertional dyspnea. The aim of the study was to determine the prognostic significance of cardiac comorbidities, ECG and baseline echocardiography in lung cancer patients with varying degrees of reduced performance status. This prospective study included 104 patients with histopathologically confirmed lung cancer, pre-qualified for systemic treatment due to metastatic or locally advanced malignancy but not eligible for thoracic surgery. The patients underwent a comprehensive cardio-oncological evaluation. Overall survival negative predictors included low ECOG 2 (Eastern Cooperative Oncology Group) performance status, stage IV (bone or liver/adrenal metastases in particular), pleural effusion, the use of analgesics and among cardiac factors, two ECG parameters: atrial fibrillation (HR = 2.39) and heart rate >90/min (HR = 1.67). Among echocardiographic parameters, RVSP > 39 mmHg was a negative predictor (HR = 2.01), while RVSP < 21 mmHg and RV free wall strain < −30% were positive predictors (HR = 0.36 and HR = 0.56, respectively), whereas RV GLS < −25.5% had a borderline significance (HR = 0.59; p = 0.05). Logistical regression analysis showed ECOG = 2 significantly correlated with the following echocardiographic parameters: increasing RVSP, RV GLS, RV free wall strain and decreasing ACT, FAC (p < 0.05). Selected echocardiographic parameters may be helpful in predicting poor performance in lung cancer patients and, supplemented with ECG evaluation, broaden the possibilities of prognostic evaluation.
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Mędrek et al. (2022) conducted a cohort in Advanced or metastatic lung cancer (n=104). Baseline electrocardiographic (e.g., atrial fibrillation) and echocardiographic abnormalities vs. Absence of these baseline abnormalities was evaluated on All-cause mortality (Overall survival) (HR 2.39). Baseline electrocardiographic parameters such as atrial fibrillation (HR 2.39) and echocardiographic findings like right ventricular systolic pressure > 39 mmHg (HR 2.01) were significant negative predictors of overall survival in lung cancer patients.
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