Zhengyi Deng MBBS, PhD , Minji Jung PharmD, PhD , Mingyi Li MHS , Jinhui Li MD, PhD , Marvin E. Langston PhD , Benjamin I. Chung MD
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引用次数: 0
Abstract
Background
Cardiovascular disease (CVD) is the leading cause of non-cancer deaths among patients with renal cell carcinoma (RCC).
Objectives
The authors sought to investigate how CVD and RCC death rates change post-RCC diagnosis and time-dependent risk factors for death, across different tumor stages.
Methods
Adults diagnosed with a first RCC from the Surveillance, Epidemiology, and End Results database (2004-2020) were included in this study. Poisson regression was used to model RCC and CVD death rates over 16-year follow-up, identifying a crossover time when the curves intersected, overall and by tumor stage. Fine-Gray competing risk models were implemented to evaluate the time-varying associations of risk factors with CVD and RCC deaths.
Results
Among overall 116,836 RCC patients, the CVD death rate overtook RCC death rate at 13.7 (95% CI: 12.0-15.4) years during follow-up. For stage I RCC patients, the crossover time was sooner at 2.8 (95% CI: 2.0-3.7) years, with all subgroups either experiencing a crossover or having a consistently higher CVD death rate than RCC death rate. No crossover time was identified for stage II-IV overall. Patients aged ≥75 years and non-Hispanic Black patients experienced a crossover time across all tumor stages. Several sociodemographic and clinical characteristics showed consistent associations with short- and long-term mortality from RCC and CVD.
Conclusions
In RCC patients, stage I individuals showed a pronounced trend where CVD death became dominant over RCC death during survivorship, with consistent patterns by different sociodemographic and clinical characteristics. Management of both cancer and CVD during critical periods is essential for improving survival outcomes in RCC patients, with strategies tailored to tumor stage.
期刊介绍:
JACC: CardioOncology is a specialized journal that belongs to the esteemed Journal of the American College of Cardiology (JACC) family. Its purpose is to enhance cardiovascular care for cancer patients by publishing high-quality, innovative scientific research and sharing evidence-based knowledge.
The journal aims to revolutionize the field of cardio-oncology and actively involve and educate professionals in both cardiovascular and oncology fields. It covers a wide range of topics including pre-clinical, translational, and clinical research, as well as best practices in cardio-oncology. Key areas of focus include understanding disease mechanisms, utilizing in vitro and in vivo models, exploring novel and traditional therapeutics (across Phase I-IV trials), studying epidemiology, employing precision medicine, and investigating primary and secondary prevention.
Amyloidosis, cardiovascular risk factors, heart failure, and vascular disease are some examples of the disease states that are of particular interest to the journal. However, it welcomes research on other relevant conditions as well.