Sleep disordered breathing and nocturnal hypoxemia are very prevalent in a lung cancer screening population and may condition lung cancer screening findings: results of the prospective Sleep Apnea In Lung Cancer Screening (SAILS) study

Warnisher, María Teresa Pérez; Cabezas, E.; Troncoso, María F.; Gómez, Teresa; Melchor, Rosario; Pinillos, Erwin Javier; Hachem, Abdulkader El; Gotera, Carolina; Rodríguez, Paula; Mahíllo, Ignacio; González-Mangado, Nicolás; Peces-Barba, Germán; Seijó, Luis

doi:10.1016/j.sleep.2018.10.020

Cited by 27 publications

(19 citation statements)

References 30 publications

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“…A study evaluating the prevalence of OSA in a lung cancer screening program found that OSA was very common in the high-risk population. Further multivariate analysis adjusted for confounders indicated that nocturnal hypoxemia was associated with positive screening ndings (nodules > 6 mm) [11]. Another study investigating the prevalence of OSA in patients with newly-diagnosed lung cancer showed a high prevalence of OSA (49%) in this population [12].…”

Section: Introductionmentioning

confidence: 82%

The Association Between Obstructive Sleep Apnea and Lung Nodule, Carcinoembryonic Antigen

Zeng

Chen

Zhao

et al. 2021

Preprint

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Purpose: The association between obstructive sleep apnea (OSA) and cancer risks gaining more and more attention. Data on the association between OSA and lung cancer risk are limited. This study is to investigate whether a link exists between Low-dose computed tomography (LDCT) scanning of the chest findings, carcinoembryonic antigen (CEA) and OSA in patients suspected of OSA.Methods: The cross-sectional study included patients aged 18 years or older who underwent continuous nocturnal polysomnography at our sleep center between February 2019 and November 2020. All subjects underwent chest LDCT and CEA. Patients with an apnea-hypopnea index(AHI) of ≥15/h were classified as clinically significant OSA group, whereas patients with an AHI ＜15/h were classified as control group.Results: A total of 277 patients were enrolled in the study. 176 patients were categorized into the OSA group, while 101 patients were categorized into the control group. There is no relationship between any OSA-related parameter and presence of lung nodule or presence of ≥6mm lung nodule in the binary logistic regression analysis. OSA group demonstrated a significant higher value of CEA than control group. Stepwise multiple linear regression analysis showed that lowest O2 saturation(β=-0.256, p＜0.001), smoking status (β=0.156, p=0.007) and age (β=0.153, p=0.008) were independent predictors of elevated CEA. Conclusion: In a group of patients suspected of OSA, we confirmed an independent correlation between nocturnal hypoxia and elevated CEA levels. OSA was not related with presence of pulmonary nodule or≥6 mm pulmonary nodule in LDCT.

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Section: Introductionmentioning

confidence: 82%

The Association Between Obstructive Sleep Apnea and Lung Nodule, Carcinoembryonic Antigen

Zeng

Chen

Zhao

et al. 2021

Preprint

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“…In recent years, multi-national cohort studies had found that OSA increases the mortality of cancer, among which lung cancer is the most common [12,13] ,Dreher et al proposed that the incidence of OSA in newly diagnosed lung cancer was 49%, in which the incidence of moderate/severe OSA was 17% [14] Perez et al proposed that the incidence of OSA in lung cancer patients was 77.5%, in which moderate/severe OSA accounted for 41.1% [12] ,which is consistent with the results of this study. It was found that 31% of lung cancer had different degrees of OSA.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a prognostic nomogram in lung cancer with obstructive sleep apnea syndrome

Hu¹,

W²,

Wu³

et al. 2021

Preprint

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Background To analyze the prognostic factors and survival rate of lung cancer patients with OSA by nomogram. Methods We developed and validated a nomogram to help improve prediction of overall survival in Lung cancer patients with OSA. The nomogram was established by a development cohort (n = 90), and the validation cohort included 38 patients. Factors in the nomogram were identified by Cox hazard analysis. We tested the accuracy of the nomograms by discrimination and calibration, and plotted decision curves to assess the benefits of nomogram-assisted decisions. At last we evaluated the risk in the two cohort. Results There were significant difference in sex, AHI, TNM stage, coronary heart disease, LSpO2, T90%, TS90% and ODI4 between lung cancer subgroup and lung cancer with OSA subgroup (P < 0.05). Lung cancer patients with OSA age(P = 0.021), AHI(P = 0.006), TNM stage(P = 0.005), cancer types(P = 0.038), BMI(P = 0.007) and were independent prognostic factor. Based on these six factors, a nomogram model was established. The c-index of internal verification was 0.802 (95% CI 0.767–0.885)。The ROC curve analysis for the nomogram show 1-year survival (AUC = 0.827), 3-year survival (AUC = 0.867), 5-year survival (AUC = 0.801) in the development cohort and 3-year survival(AUC = 0.863) in the validation cohort is with good accuracy. The calibration curve shows that the survival probability of this prediction model is in good agreement with the actual situation at 1, 3 and 5 years with good consistency. decision curve analysis(DCA)suggests that the net benefit of decision-making with this nomogram is higher, especially in the probability interval of < 20% threshold. Conclusions Age, AHI,TNM stage, cancer types, BMI and ODI4 are independent risk factors for prognosis of lung cancer patients with OSAS༌the nomogram can predict the prognosis of patients and guide individualized treatment.

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“…This hypothesis is strengthened by epidemiological observations indicating a considerably highly prevalence of OSA in cancer populations. For example, 50% of patients with lung cancer were also diagnosed with moderate-to-severe OSA [44,45]. Some studies have also suggested that sleep disordered breathing may be associated with cancer aggressiveness and worse prognosis [37,46,47].…”

Section: Discussionmentioning

confidence: 99%

Telomere Length and Risk of Major Adverse Cardiac Events and Cancer in Obstructive Sleep Apnea Patients

Polonis

Sompalli

Becari

et al. 2019

Cells

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Telomere length (TL) is associated with cardiovascular disease (CVD) and cancer. Obstructive sleep apnea (OSA) is also linked to higher risk of CVD and cancer, and to TL. We investigated the association between TL and risk of major adverse cardiac events (MACE) and cancer in OSA patients. We studied 210 individuals undergoing sleep-related studies between 2000 and 2007. Baseline characteristics and follow-up data (available in 164 subjects) were obtained from clinic records. Incidence rates were calculated for the entire group and by OSA status. Hazard ratios were calculated to estimate effects of OSA and TL on risk of MACE and cancer. In total, 32 individuals (20%) developed MACE and/or cancer during 12.7-year follow-up. The OSA group had a higher likelihood of cancer (16.0 vs. 4.9 events per 1000 person-years, P = 0.044) but no clear evidence of an elevated incidence of MACE (10.8 vs. 4.8 events per 1000 person-years, P = 0.293) compared to the non-OSA group. There was no association between TL and MACE- (HR = 1.01, 95% CI 0.78–1.28), or cancer-risk (HR = 1.18, 95% CI 0.96–1.43). Our study warrants further investigation of any modulating effect of OSA on TL and the risk of MACE and cancer.

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Sleep disordered breathing and nocturnal hypoxemia are very prevalent in a lung cancer screening population and may condition lung cancer screening findings: results of the prospective Sleep Apnea In Lung Cancer Screening (SAILS) study

Cited by 27 publications

References 30 publications

The Association Between Obstructive Sleep Apnea and Lung Nodule, Carcinoembryonic Antigen

The Association Between Obstructive Sleep Apnea and Lung Nodule, Carcinoembryonic Antigen

Development and validation of a prognostic nomogram in lung cancer with obstructive sleep apnea syndrome

Telomere Length and Risk of Major Adverse Cardiac Events and Cancer in Obstructive Sleep Apnea Patients

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