The risk of death from heart disease in patients with nonsmall cell lung cancer who receive postoperative radiotherapy: Analysis of the surveillance, epidemiology, and end results database

Brian E. Lally, Frank C. Detterbeck, Ann M. Geiger, Charles Thomas, Mitchell Machtay, Antonius A. Miller, Lynn D. Wilson, Timothy E. Oaks, W. Jeffrey Petty, Mike E. Robbins, A. William Blackstock

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Abstract

BACKGROUND. This study was designed to investigate whether the mortality from heart disease, a manifestation of intercurrent disease after postoperative radiotherapy (PORT), has decreased over time for patients with nonsmall cell lung cancer (NSCLC). METHODS. The 17-registry 1973 to 2003 dataset from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program was used to create a cohort of patients with NSCLC who had evidence of ipsilateral lymph node involvement diagnosed from 1983 to 1993 and who underwent pnuemonectomy/lobectomy (n = 6148 patients). Heart disease mortality was the primary endpoint: Deaths from other causes were censored, and surviving patients were censored at 10 years. The independent variable was PORT use, and adjustment variables included age at diagnosis, sex, race, year of diagnosis, laterality, location, histology, and the operation performed. RESULTS. Multivariate analysis revealed that PORT use was associated with an increase in heart disease mortality (hazards ratio [HR], 1.30; 95% confidence interval [95% CI], 1.04-1.61; P = .0193) along with older age, male sex, African-American race, and earlier year of diagnosis. The association was confirmed in the cohort that was diagnosed from 1983 to 1988 (HR, 1.49; 95% CI, 1.11-2.01 [P = .0090]) but not for the cohort that was diagnosed from 1989 to 1993 (HR, 1.08; 95% CI, 0.79-1.48 [P = .6394]). CONCLUSIONS. The results from this study demonstrated that the risk of heart disease mortality associated with PORT has declined in more recent years. This may be secondary to improvements in the treatment planning and delivery of thoracic radiotherapy. Properly designed, prospective, adjuvant trials will be needed to verify these findings.

Original languageEnglish (US)
Pages (from-to)911-917
Number of pages7
JournalCancer
Volume110
Issue number4
DOIs
StatePublished - Aug 15 2007

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Non-Small Cell Lung Carcinoma
Heart Diseases
Epidemiology
Radiotherapy
Databases
Mortality
Confidence Intervals
SEER Program
National Cancer Institute (U.S.)
African Americans
Registries
Early Diagnosis
Cause of Death
Histology
Thorax
Multivariate Analysis
Lymph Nodes
Therapeutics

Keywords

  • Adjuvant therapy
  • And End Results
  • Cardiac mortality
  • Epidemiology
  • Intercurrent death
  • Nonsmall cell lung cancer
  • Radiation therapy
  • Surgery
  • Surveillance

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

The risk of death from heart disease in patients with nonsmall cell lung cancer who receive postoperative radiotherapy : Analysis of the surveillance, epidemiology, and end results database. / Lally, Brian E.; Detterbeck, Frank C.; Geiger, Ann M.; Thomas, Charles; Machtay, Mitchell; Miller, Antonius A.; Wilson, Lynn D.; Oaks, Timothy E.; Petty, W. Jeffrey; Robbins, Mike E.; Blackstock, A. William.

In: Cancer, Vol. 110, No. 4, 15.08.2007, p. 911-917.

Research output: Contribution to journalArticle

Lally, BE, Detterbeck, FC, Geiger, AM, Thomas, C, Machtay, M, Miller, AA, Wilson, LD, Oaks, TE, Petty, WJ, Robbins, ME & Blackstock, AW 2007, 'The risk of death from heart disease in patients with nonsmall cell lung cancer who receive postoperative radiotherapy: Analysis of the surveillance, epidemiology, and end results database', Cancer, vol. 110, no. 4, pp. 911-917. https://doi.org/10.1002/cncr.22845
Lally, Brian E. ; Detterbeck, Frank C. ; Geiger, Ann M. ; Thomas, Charles ; Machtay, Mitchell ; Miller, Antonius A. ; Wilson, Lynn D. ; Oaks, Timothy E. ; Petty, W. Jeffrey ; Robbins, Mike E. ; Blackstock, A. William. / The risk of death from heart disease in patients with nonsmall cell lung cancer who receive postoperative radiotherapy : Analysis of the surveillance, epidemiology, and end results database. In: Cancer. 2007 ; Vol. 110, No. 4. pp. 911-917.
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abstract = "BACKGROUND. This study was designed to investigate whether the mortality from heart disease, a manifestation of intercurrent disease after postoperative radiotherapy (PORT), has decreased over time for patients with nonsmall cell lung cancer (NSCLC). METHODS. The 17-registry 1973 to 2003 dataset from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program was used to create a cohort of patients with NSCLC who had evidence of ipsilateral lymph node involvement diagnosed from 1983 to 1993 and who underwent pnuemonectomy/lobectomy (n = 6148 patients). Heart disease mortality was the primary endpoint: Deaths from other causes were censored, and surviving patients were censored at 10 years. The independent variable was PORT use, and adjustment variables included age at diagnosis, sex, race, year of diagnosis, laterality, location, histology, and the operation performed. RESULTS. Multivariate analysis revealed that PORT use was associated with an increase in heart disease mortality (hazards ratio [HR], 1.30; 95{\%} confidence interval [95{\%} CI], 1.04-1.61; P = .0193) along with older age, male sex, African-American race, and earlier year of diagnosis. The association was confirmed in the cohort that was diagnosed from 1983 to 1988 (HR, 1.49; 95{\%} CI, 1.11-2.01 [P = .0090]) but not for the cohort that was diagnosed from 1989 to 1993 (HR, 1.08; 95{\%} CI, 0.79-1.48 [P = .6394]). CONCLUSIONS. The results from this study demonstrated that the risk of heart disease mortality associated with PORT has declined in more recent years. This may be secondary to improvements in the treatment planning and delivery of thoracic radiotherapy. Properly designed, prospective, adjuvant trials will be needed to verify these findings.",
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T2 - Analysis of the surveillance, epidemiology, and end results database

AU - Lally, Brian E.

AU - Detterbeck, Frank C.

AU - Geiger, Ann M.

AU - Thomas, Charles

AU - Machtay, Mitchell

AU - Miller, Antonius A.

AU - Wilson, Lynn D.

AU - Oaks, Timothy E.

AU - Petty, W. Jeffrey

AU - Robbins, Mike E.

AU - Blackstock, A. William

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N2 - BACKGROUND. This study was designed to investigate whether the mortality from heart disease, a manifestation of intercurrent disease after postoperative radiotherapy (PORT), has decreased over time for patients with nonsmall cell lung cancer (NSCLC). METHODS. The 17-registry 1973 to 2003 dataset from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program was used to create a cohort of patients with NSCLC who had evidence of ipsilateral lymph node involvement diagnosed from 1983 to 1993 and who underwent pnuemonectomy/lobectomy (n = 6148 patients). Heart disease mortality was the primary endpoint: Deaths from other causes were censored, and surviving patients were censored at 10 years. The independent variable was PORT use, and adjustment variables included age at diagnosis, sex, race, year of diagnosis, laterality, location, histology, and the operation performed. RESULTS. Multivariate analysis revealed that PORT use was associated with an increase in heart disease mortality (hazards ratio [HR], 1.30; 95% confidence interval [95% CI], 1.04-1.61; P = .0193) along with older age, male sex, African-American race, and earlier year of diagnosis. The association was confirmed in the cohort that was diagnosed from 1983 to 1988 (HR, 1.49; 95% CI, 1.11-2.01 [P = .0090]) but not for the cohort that was diagnosed from 1989 to 1993 (HR, 1.08; 95% CI, 0.79-1.48 [P = .6394]). CONCLUSIONS. The results from this study demonstrated that the risk of heart disease mortality associated with PORT has declined in more recent years. This may be secondary to improvements in the treatment planning and delivery of thoracic radiotherapy. Properly designed, prospective, adjuvant trials will be needed to verify these findings.

AB - BACKGROUND. This study was designed to investigate whether the mortality from heart disease, a manifestation of intercurrent disease after postoperative radiotherapy (PORT), has decreased over time for patients with nonsmall cell lung cancer (NSCLC). METHODS. The 17-registry 1973 to 2003 dataset from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program was used to create a cohort of patients with NSCLC who had evidence of ipsilateral lymph node involvement diagnosed from 1983 to 1993 and who underwent pnuemonectomy/lobectomy (n = 6148 patients). Heart disease mortality was the primary endpoint: Deaths from other causes were censored, and surviving patients were censored at 10 years. The independent variable was PORT use, and adjustment variables included age at diagnosis, sex, race, year of diagnosis, laterality, location, histology, and the operation performed. RESULTS. Multivariate analysis revealed that PORT use was associated with an increase in heart disease mortality (hazards ratio [HR], 1.30; 95% confidence interval [95% CI], 1.04-1.61; P = .0193) along with older age, male sex, African-American race, and earlier year of diagnosis. The association was confirmed in the cohort that was diagnosed from 1983 to 1988 (HR, 1.49; 95% CI, 1.11-2.01 [P = .0090]) but not for the cohort that was diagnosed from 1989 to 1993 (HR, 1.08; 95% CI, 0.79-1.48 [P = .6394]). CONCLUSIONS. The results from this study demonstrated that the risk of heart disease mortality associated with PORT has declined in more recent years. This may be secondary to improvements in the treatment planning and delivery of thoracic radiotherapy. Properly designed, prospective, adjuvant trials will be needed to verify these findings.

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KW - And End Results

KW - Cardiac mortality

KW - Epidemiology

KW - Intercurrent death

KW - Nonsmall cell lung cancer

KW - Radiation therapy

KW - Surgery

KW - Surveillance

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