The impact of comorbidities on the all-cause mortality of surgically treated non-small cell lung cancer patients - visualization with the aid of a comorbidome.
Julia Zimmermann, Julia Walter, Mircea Gabriel Stoleriu, Julia Kovács, Gökce Yavuz, Fuad Damirov, Niels Reinmuth, Martina Merk, Rudolf A Hatz, Amanda Tufman, Christian P Schneider
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引用次数: 0
Abstract
Backgrounds: Lung cancer patients often have multiple comorbidities. This study aimed to determine which comorbidities had an impact on all-cause mortality in lung cancer patients who had undergone surgical treatment.
Methods: This retrospective study reviewed data from all lung cancer patients who underwent lobectomy or segmentectomy at the Lung Cancer Center Munich between 2011 and 2020. We compared numerical outcomes between patients with minimally invasive surgery and patients with thoracotomy using t-test, and categorical outcomes using Chi2-test or fishers exact test when cell counts were < 6. We used multivariate Cox Regression to model the association between comorbidities and overall survival.
Results: 1658 patients (556 minimally invasive,1102 thoracotomy) were included. Across the entire population the comorbidity with the strongest association to death was chronic lymphatic leukemia (HR = 5.15, p = < 0.001), followed by pulmonary fibrosis (HR = 4.06, p = < 0.001), mild liver disease (HR = 2.18, p = 0.02), peripheral arterial disease (HR = 1.48, p = 0.04) and chronic obstructive pulmonary disease (HR = 1.42, p = < 0.01). In the minimally invasive surgery group chronic lymphatic leukemia was most strongly associated with death (HR = 14.31, p = 0.01). This was followed by mild liver disease (HR = 5.01, p = 0.01) and myocardial infarction (HR = 2.45, p = 0.04). Whereas in the thoracotomy group the strongest associations were fibrosis (HR = 4.20, p = < 0.001) and COPD (HR = 1.51,p = < 0.01).
Conclusion: Most of the comorbidities analyzed do not have a major impact on all-cause mortality after lung surgery. Those that do have a high impact tend to have a very low prevalence.
背景:肺癌患者通常有多种合并症。本研究旨在确定哪些合并症对接受手术治疗的肺癌患者的全因死亡率有影响。方法:这项回顾性研究回顾了2011年至2020年期间在慕尼黑肺癌中心接受肺叶切除术或节段切除术的所有肺癌患者的数据。我们采用t检验比较微创手术患者和开胸手术患者的数值结果,并在细胞计数时采用chi2检验或fisher精确检验比较分类结果。结果:纳入1658例患者(556例微创手术,1102例开胸手术)。在整个人群中,与死亡相关性最强的合并症是慢性淋巴白血病(HR = 5.15, p =)。结论:分析的大多数合并症对肺部手术后的全因死亡率没有重大影响。那些影响很大的疾病的患病率往往很低。