Comparing Survival in Patients With Lung Cancer With and Without a History of Common Autoimmune Disease.

Autor:	Dedousis D; Department of Internal Medicine/Case Western Reserve University, UH Cleveland Medical Center, University Hospitals, Cleveland, Ohio., Vassiliou AN; Case Western Reserve University, Cleveland, Ohio., Cao S; Department of Population and Quantitative Health Sciences, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio., Yammani D; UH Seidman Cancer Center, UH Cleveland Medical Center, University Hospitals, Cleveland, Ohio., Kyasaram RK; UH Seidman Cancer Center, UH Cleveland Medical Center, University Hospitals, Cleveland, Ohio., Shanahan J; UH Seidman Cancer Center/Case Western Reserve University, Case Comprehensive Cancer Center, UH Cleveland Medical Center, University Hospitals, Cleveland, Ohio., Keinath MC; Department of Pathology, UH Cleveland Medical Center, University Hospitals, Cleveland, Ohio., Zhang AL; Department of Internal Medicine/Case Western Reserve University, UH Cleveland Medical Center, University Hospitals, Cleveland, Ohio., Hsu ML; Department of Hematology and Oncology, UH Seidman Cancer Center, UH Cleveland Medical Center, University Hospitals, Cleveland, Ohio., Fu P; Department of Population and Quantitative Health Sciences, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio., Dowlati A; Department of Hematology and Oncology/Case Western Reserve University, Case Comprehensive Cancer Center, UH Seidman Cancer Center, UH Cleveland Medical Center, University Hospitals, Cleveland, Ohio.
Jazyk:	angličtina
Zdroj:	JTO clinical and research reports [JTO Clin Res Rep] 2022 Jul 05; Vol. 3 (9), pp. 100375. Date of Electronic Publication: 2022 Jul 05 (Print Publication: 2022).
DOI:	10.1016/j.jtocrr.2022.100375
Abstrakt:	Introduction: Autoimmune disease has both a predisposing and a protective effect toward malignancy. Though studies have investigated the risk of malignancy in patients with autoimmune disease, there is limited research on how autoimmunity affects survival. Methods: This study compared survival in patients with lung cancer with and without autoimmune disease. Patients with lung cancer were culled from the Surveillance, Epidemiology, and End Results Medicare databases (2007-2014), and autoimmune diseases were identified using diagnosis codes. Results: The overall prevalence of investigated autoimmune diseases among the 112,445 patients was 22.7%. Overall survival (OS) ( p < 0.0001) was longer and cancer-specific mortality (CSM) ( p < 0.0001) reduced among patients with autoimmune disease. Median OS was 5 months higher. Improved OS and CSM were also apparent in disease stages 1, 3, and 4 in the NSCLC and SCLC subgroups ( p < 0.0001) and across most specific autoimmune diseases. After adjusting for the effects of age, sex, race, disease stage, and chronic kidney disease, autoimmune disease was still predictive of higher OS (hazard ratio = 1.23, 95% confidence interval: 1.21-1.25, p < 0.0001) and reduced CSM (hazard ratio = 1.16, 95% confidence interval: 1.14-1.18, p < 0.0001). Conclusions: The prevalence of rheumatoid arthritis, inflammatory bowel disease, and systemic lupus erythematous was highly enriched compared with the general population. The improvement in OS and CSM was larger in NSCLC than in SCLC, suggesting a larger role for the immune system in NSCLC. Alternate explanations for the improved survival include lead time bias, better access to health care, and a survival or autoimmunity-inducing genetic factor. (© 2022 The Authors.)
Databáze:	MEDLINE
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