Key result
Among long-term lung cancer survivors, primary lung cancer remained a major cause of death (21.8% at 5-10 years, 12% at >10 years), with cardiac and pulmonary diseases also contributing significantly.
Cohort (n=78,701)
Yes
Cardiac disease is a significant cause of mortality in long-term lung cancer survivors, accounting for nearly 7% of deaths in those surviving beyond 5 years.
Answers are grounded in this paper and cite their sources.
Cardiac disease contributes to late mortality in lung cancer survivors; hypothesis-generating for cardio-oncology surveillance strategies.
BACKGROUND: Long-term (>5 years) lung cancer survivors represent a small but distinct subgroup of lung cancer patients and information about the causes of death of this subgroup is scarce. METHODS: The Surveillance, Epidemiology and End Results (SEER) database (1988-2008) was utilized to determine the causes of death of long-term survivors of lung cancer. Survival analysis was conducted using Kaplan-Meier analysis and multivariate analysis was conducted using a Cox proportional hazard model. Clinicopathological characteristics and survival outcomes were assessed for the whole cohort. RESULTS: A total of 78,701 lung cancer patients with >5 years survival were identified. This cohort included 54,488 patients surviving 5-10 years and 24,213 patients surviving >10 years. Among patients surviving 5-10 years, 21.8% were dead because of primary lung cancer, 10.2% were dead because of other cancers, 6.8% were dead because of cardiac disease and 5.3% were dead because of non-malignant pulmonary disease. Among patients surviving >10 years, 12% were dead because of primary lung cancer, 6% were dead because of other cancers, 6.9% were dead because of cardiac disease and 5.6% were dead because of non-malignant pulmonary disease. On multivariate analysis, factors associated with longer cardiac-disease-specific survival in multivariate analysis include younger age at diagnosis (p < .0001), white race (vs. African American race) (p = .005), female gender (p < .0001), right-sided disease (p = .003), adenocarcinoma (vs. large cell or small cell carcinoma), histology and receiving local treatment by surgery rather than radiotherapy (p < .0001). CONCLUSION: The probability of death from primary lung cancer is still significant among other causes of death even 20 years after diagnosis of lung cancer. Moreover, cardiac as well as non-malignant pulmonary causes contribute a considerable proportion of deaths in long-term lung cancer survivors.
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Omar Abdel‐Rahman (2017) conducted a cohort in Lung cancer (n=78,701). Long-term lung cancer survival was evaluated on Causes of death. Among long-term lung cancer survivors, primary lung cancer remained a major cause of death (21.8% at 5-10 years, 12% at >10 years), with cardiac and pulmonary diseases also contributing significantly.
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