Clinico-Pathological Features and Management of Lung Cancer Patients with Atherosclerotic Vascular Diseases

Abstract

Purpose: Increased numbers of patients with both lung cancer and atherosclerotic vascular disease (AVD) may be expected in the future. The aim of this study was to report the incidence of lung cancer in patients with AVD and to discuss patient characteristics and management. Method: A total of 638 patients who underwent AVD treatment were investigated. Results: Lung cancer was observed in 17 (2.7%) of 638 patients studied. The proportion of smoking history was significantly higher in patients with lung cancer (p = 0.0091).The pack-year index in patients with lung cancer was significantly higher than that in patients without lung cancer (p = 0.0073). Although 4 of 6 (66.7%) patients with concomitant lung cancer and AVD had stage I or II lung cancer, 5 of 7 (71.4%) patients with lung cancer diagnosed after AVD treatment had stage III or IV lung cancer. In patients with lung cancer found after AVD treatment, only 1 of 7 patients underwent surgical resections. The time until lung cancer was 12 to 198 months with a mean of 62.5 months after AVD treatment. In concomitant cases, priority was given to AVD treatment in all 5 cases, and there were no serious events after the postoperative course. Conclusions: Both patients with a smoking history and heavy smokers were at high risk for lung cancer, and most lung cancers found after AVD treatment were in the advanced stages and had poor prognoses. Therefore, we recommend careful and routine follow-up for screening lung cancer after AVD treatment. Keywords: AVD, lung cancer, smoking history IntroductionLung cancer is the leading cause of cancer death both in Japan and worldwide, and the incidence of lung cancer increases with age.1 Smoking is the predominant risk factor for the development of lung cancer.2 Moreover, smoking status has been consistently reported to be a statistically significant prognostic factor in patients with lung cancer.3 In addition, smoking and advanced age are conventional risk factors for vascular disease. 4 A recent systematic review of large studies of smoking-related outcomes demonstrated an association between smoking and aortic aneurysm. Purpose: Increased numbers of patients with both lung cancer and atherosclerotic vascular disease (AVD) may be expected in the future. The aim of this study was to report the incidence of lung cancer in patients with AVD and to discuss patient characteristics and management. Method: A total of 638 patients who underwent AVD treatment were investigated. Results: Lung cancer was observed in 17 (2.7%) of 638 patients studied. The proportion of smoking history was significantly higher in patients with lung cancer (p = 0.0091).The pack-year index in patients with lung cancer was significantly higher than that in patients without lung cancer (p = 0.0073). Although 4 of 6 (66.7%) patients with concomitant lung cancer and AVD had stage I or II lung cancer, 5 of 7 (71.4%) patients with lung cancer diagnosed after AVD treatment had stage III or IV lung cancer. In patients with lung cancer found after AVD treatment, only 1...

Peripheral arterial disease and systematic detection of circulating tumor cells: rationale and design of the DETECTOR prospective cohort study

“…The clinical benefit of a special workup for neoplasms in patients with PAD and a history of cigarette smoking has never been investigated. Furthermore, most patients diagnosed with cancer in the follow-up after PAD treatment exhibited advanced stage and poor survival [11, 34]. The clinical benefit of early cancer detection in this population may thus be expected.…”

“…Recent epidemiological evidence confirms that PAD as well as abdominal aortic aneurysm (AAA) are markers for the development of lung cancer [6–8], independently of age [9, 10]. Because of an advanced disease stage at the time of diagnosis, only a few patients with lung cancer after atherosclerotic vascular disease management may benefit from surgical excision [11]. Selection of patients with prevalent atherosclerotic peripheral disease may thus dramatically increase the benefit of cancer screening.…”