Are cardiovascular comorbidities always associated with a worse prognosis in patients with lung cancer?

Abstract

Many factors contribute to mortality in lung cancer, including the presence of concomitant cardiovascular disease. In the treatment of early stage of lung cancer, the presence of comorbidities and occurence of cardiotoxicity may be prognostic. The effect of cardiotoxicity of radiotherapy and chemoradiotherapy on overall survival has been documented. Acute arterial and venous thromboembolic events seem to correlate with the degree of the histological malignancy, its clinical advancement, and even with optimal cardiac treatment, they may influence the survival time. In the case of high-grade and advanced lung cancer stage especially in an unresectable stadium, the prognosis depends primarily on the factors related to the histopathological and molecular diagnosis. Electrocardiographic and echocardiographic abnormalities may be prognostic factors, as they seem to correlate with the patient's performance status as well as tumor localization and size.

Characteristics of patients with newly diagnosed hematological malignancies referred for echocardiography

“…Echocardiography should be part of the baseline cardiovascular risk stratification before anticancer treatment. The coexistence of cardiac diseases may be associated with a worse prognosis in patients treated for cancer ( 20 ). Cancer and its treatment favor the development of new and progression of existing cardiac diseases.…”

Cardiac Arrhythmias in Oncological Patients—Epidemiology, Risk Factors, and Management within the Context of the New ESC 2022 Guidelines

“…The overall incidence of AF in general population varies from 1 to 2%, whereas among oncological patients, it reaches between 5% and 16%, depending on the risk factors and cancer type [ 3 , 4 ]. Korean Nationwide Population-Based Study showed that AF is strongly connected with the presence of hematological and intrathoracic cancers with HR = 2.69 for esophageal cancer and HR = 2.39 for lung cancer [ 5 •, 6 ]. In a group of 4,324,545 patients, 316,040 (7.3%) of whom had a cancer diagnosis, the incidence of AF was increased in all cancer types, in comparison to patients without cancer and reached 17.4 per 1000 person-years (PY) and 3.7 per 1000 PY, respectively, during 12 years of follow-up [ 7 ].…”

Risk factors for enhanced recovery after surgery failure in patients undergoing lung cancer resection with concomitant cardiovascular disease: A single-center retrospective study

“… 2 , 3 Studies have shown that patients with CVD, such as heart disease, vascular disease, and hypertension, have a 67% increased risk of developing lung cancer, and patients with lung cancer and comorbid CVD, such as coronary artery disease (CAD), hypertension, arrhythmias, and peripheral atherosclerosis, have a 30% increased risk of death compared to patients with lung cancer without comorbidities. 4 , 5 Lobectomy is the most important treatment for early stage lung cancer. 6 Postoperative complications, such as prolonged hospital stay, unplanned reoperation after surgery, and readmission or death, affects patients' quality of life, reduces hospital efficiency, and reduced their social and economic benefits.…”