Correlation between blast percentage in myelofibrosis and outcomes: A single-center experience.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18562-e18562 ◽  
Author(s):  
Lucia Masarova ◽  
Prithviraj Bose ◽  
Kate Newberry ◽  
Abdallah Abou Zahr ◽  
Jorge E. Cortes ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Cox Regression ◽  
Chronic Phase ◽  
Cancer Center ◽  
Normal Range ◽  
Single Center Experience ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Systemic Symptoms ◽  
Md Anderson

e18562 Background: Patients with accelerated phase (AP) myelofibrosis (MF; >10% blasts [BL] in bone marrow [BM] or peripheral blood [PB]) have shorter overall survival (OS) than those in the chronic phase (<10% BM/PB BL). However, outcomes of patients with “lower” BM/PB BL (1-9%) are not well described. Methods: Clinical characteristics and OS of 1099 patients with MF who presented to MD Anderson Cancer Center between years 1984 – 2013 were retrospectively evaluated. Kaplan-Meier analysis and Cox regression models were used for calculations and comparisons. Results: PB and BM BL were available for 1038 (94%) patients at presentation. Five percent had AP, 10% had 5-9% BM or PB BL; 45% had < 5% BM BL and 1% (n=282), 2% (n=110), 3% (n=47) or 4% (n=27) PB BL; and 40% had < 5% BM BL and 0% PB BL (normal range). OS was similar among patients with 5-9% BM or 4-9% PB BL and those in AP (P>0.05). OS was also similar among patients with BL in the normal range and those with <5% BM and 1-3% PB BL (p>0.05). By grouping patients with similar OS, we have identified 2 groups with distinctive OS of 54 and 27 months, respectively (Table; p<0.001; HR = 1.81 [95%CI 1.5-2.2]). Five-year leukemia free survival was 65% for those in AP, 76% for ≥ 5-9% BM or ≥ 4-9% PB blasts, and 91% for < 4% BM or ≤ 3% PB BL (P<0.001). Clinical characteristics were similar for patients in the AP and with ≥ 5-9% BM or ≥ 4-9% PB blasts. Both groups had significantly higher leukocytes, lower hemoglobin and platelet levels, and were more likely to be transfusion dependent, have systemic symptoms, and unfavorable karyotype than patients with ≤ 4% BM or ≤ 3% PB blasts. There was no significant difference in age, splenomegaly, BM fibrosis grade, or distribution of JAK2, MPL and CALR mutations among these groups. Conclusions: Patients with ≥ 4% PB or ≥ 5% BM BL have OS that appears to be the same as those with >10% BL, suggesting that these patients may require a more aggressive treatment approach. [Table: see text]

Obesity Is Poor Prognostic Factor in Lower Risk Myelodysplastic Syndrome

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5018-5018
Author(s):  
Asmita Mishra ◽  
Dana E Rollison ◽  
Najla H Al Ali ◽  
Maria Corrales-Yepez ◽  
Pearlie K Epling-Burnette ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factor ◽  
Myelodysplastic Syndrome ◽  
Lower Risk ◽  
Cox Regression ◽  
Cancer Center ◽  
Kaplan Meier ◽  
Baseline Characteristics ◽  
Md Anderson ◽  
The Impact

Abstract Abstract 5018 Background: Obesity was associated with a more than 2-fold greater risk of myelodysplastic syndrome (MDS) in a recent epidemiological study (Ma et al, Am J Epidemiol. 2009 June 15; 169(12): 1492–1499). The impact of obesity on outcome of disease in patients with an established diagnosis of MDS has not been studied. We examined the prognostic value of obesity in a large cohort of lower risk MDS patients treated at the Moffitt Cancer Center (MCC). Methods: Data were collected retrospectively from the Moffitt Cancer Center (MCC) MDS database and individual charts reviewed. The primary objective was to evaluate the impact of obesity on overall survival (OS) in lower risk patients with MDS. Patients with low or intermediate-1 (int-1) risk disease by International Prognostic Scoring System (IPSS) were included. Obesity was defined as a body mass index (BMI) ≥ 30 (Standard definition) measured at time of referral to MDS program at MCC. Patients were divided into two groups according to BMI ≥ 30 or BMI < 30. All analyses were conducted using SPSS version 19.0. Chi square and independent t-test were used to compare baseline characteristics between the 2 groups for categorical and continuous variables, respectively. The Kaplan–Meier method was used to estimate median overall survival. Log rank test was used to compare Kaplan–Meier survival estimates between two groups. Cox regression was used for multivariable analysis. Results: Between January 2001 and December 2009, 479 low/int-1 IPSS risk MDS patients were included. Among those, 132 (27.6%) had BMI ≥ 30 and 325 (67.8%) had BMI <30; BMI was missing in 22 patients (4.6%). The baseline characteristics between the two groups were comparable. No difference was noted in mean age, WHO subtype, karyotype, MD Anderson risk model group, red blood cell transfusion dependency (RBC-TD), or serum ferritin (Table-1). The median OS was 59 mo (95%CI 48–70) in patients with BMI <30 compared to 44 (95%CI 38–50) in patients with BMI ≥ 30. (p=0.03). There was no difference in rate of AML transformation according to BMI, 12.9% and 15.7% respectively for BMI ≥ 30 and BMI <30. (P=0.3). In Cox regression analysis obesity predicted inferior OS (Hazard ratio (HR) 1.7 (95%CI 1.15–2.4) (P=0.007) after adjustment for age, MD Anderson risk group, serum ferritin, RBC-TD, use of hypomethylating agents and tobacco use. Conclusion: Our data suggest that obesity is an independent adverse prognostic factor for OS in patients with lower risk MDS. Obesity may be associated with other comorbidities and metabolic dearrangements that contribute to the pathogenesis of the underlying disease. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Association of Comorbidities With Overall Survival in Myelodysplastic Syndrome: Development of a Prognostic Model

2011 ◽  
Vol 29 (16) ◽  
pp. 2240-2246 ◽  
Author(s):  
Kiran Naqvi ◽  
Guillermo Garcia-Manero ◽  
Sagar Sardesai ◽  
Jeong Oh ◽  
Carlos E. Vigil ◽  
...  
Keyword(s):  
Myelodysplastic Syndrome ◽  
Median Survival ◽  
Prognostic Model ◽  
Cox Regression ◽  
Risk Groups ◽  
International Prognostic Scoring System ◽  
Cancer Center ◽  
Kaplan Meier ◽  
Severe Comorbidity ◽  
Md Anderson

Purpose Patients with cancer often experience comorbidities that may affect their prognosis and outcome. The objective of this study was to determine the effect of comorbidities on the survival of patients with myelodysplastic syndrome (MDS). Patients and Methods We conducted a retrospective cohort study of 600 consecutive patients with MDS who presented to MD Anderson Cancer Center from January 2002 to December 2004. The Adult Comorbidity Evaluation-27 (ACE-27) scale was used to assess comorbidities. Data on demographics, International Prognostic Scoring System (IPSS), treatment, and outcome (leukemic transformation and survival) were collected. Kaplan-Meier methods and Cox regression were used to assess survival. A prognostic model incorporating baseline comorbidities with age and IPSS was developed to predict survival. Results Overall median survival was 18.6 months. According to the ACE-27 categories, median survival was 31.8, 16.8, 15.2, and 9.7 months for those with none, mild, moderate, and severe comorbidities, respectively (P < .001). Adjusted hazard ratios were 1.3, 1.6, and 2.3 for mild, moderate, and severe comorbidities, respectively, compared with no comorbidities (P < .001). A final pognostic model including age, IPSS, and comorbidity score predicted median survival of 43.0, 23.0, and 9.0 months for lower-, intermediate-, and high-risk groups, respectively (P < .001). Conclusion Comorbidities have a significant impact on the survival of patients with MDS. Patients with severe comorbidity had a 50% decrease in survival, independent of age and IPSS risk group. A comprehensive assessment of the severity of comorbidities helps predict survival in patients with MDS.

scholarly journals Comprehensive analysis of genomic mutation signature and tumor mutation burden for prognosis of intrahepatic cholangiocarcinoma

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rui Zhang ◽  
Qi Li ◽  
Jialu Fu ◽  
Zhechuan Jin ◽  
Jingbo Su ◽  
...  
Keyword(s):  
Intrahepatic Cholangiocarcinoma ◽  
Cox Regression ◽  
Tnm Stage ◽  
Gene Set Enrichment Analysis ◽  
Functional Enrichment ◽  
Tumor Mutation Burden ◽  
Kaplan Meier ◽  
Mutation Burden ◽  
Significant Difference ◽  
Genomic Mutation

Abstract Background Intrahepatic cholangiocarcinoma (iCCA) is a highly lethal malignancy of the biliary tract. Analysis of somatic mutational profiling can reveal new prognostic markers and actionable treatment targets. In this study, we explored the utility of genomic mutation signature and tumor mutation burden (TMB) in predicting prognosis in iCCA patients. Methods Whole-exome sequencing and corresponding clinical data were collected from the ICGC portal and cBioPortal database to detect the prognostic mutated genes and determine TMB values. To identify the hub prognostic mutant signature, we used Cox regression and Lasso feature selection. Mutation-related signature (MRS) was constructed using multivariate Cox regression. The predictive performances of MRS and TMB were assessed using Kaplan–Meier (KM) analysis and receiver operating characteristic (ROC). We performed a functional enrichment pathway analysis using gene set enrichment analysis (GSEA) for mutated genes. Based on the MRS, TMB, and the TNM stage, a nomogram was constructed to visualize prognosis in iCCA patients. Results The mutation landscape illustrated distributions of mutation frequencies and types in iCCA, and generated a list of most frequently mutated genes (such as Tp53, KRAS, ARID1A, and IDH1). Thirty-two mutated genes associated with overall survival (OS) were identified in iCCA patients. We obtained a six-gene signature using the Lasso and Cox method. AUCs for the MRS in the prediction of 1-, 3-, and 5-year OS were 0.759, 0.732, and 0.728, respectively. Kaplan–Meier analysis showed a significant difference in prognosis for patients with iCCA having a high and low MRS score (P < 0.001). GSEA was used to show that several signaling pathways, including MAPK, PI3K-AKT, and proteoglycan, were involved in cancer. Conversely, survival analysis indicated that TMB was significantly associated with prognosis. GSEA indicated that samples with high MRS or TMB also showed an upregulated expression of pathways involved in tumor signaling and the immune response. Finally, the predictive nomogram (that included MRS, TMB, and the TNM stage) demonstrated satisfactory performance in predicting survival in patients with iCCA. Conclusions Mutation-related signature and TMB were associated with prognosis in patients with iCCA. Our study provides a valuable prognostic predictor for determining outcomes in patients with iCCA.

scholarly journals The prognosis of hepatoid adenocarcinoma of the stomach: a propensity score-based analysis

2020 ◽  
Author(s):  
Kai Zhou ◽  
Anqiang Wang ◽  
Sheng Ao ◽  
Jiahui Chen ◽  
Ke Ji ◽  
...  
Keyword(s):  
Propensity Score ◽  
Cox Regression ◽  
Radical Surgery ◽  
Survival Rates ◽  
Cancer Type ◽  
Radical Gastrectomy ◽  
Hepatoid Adenocarcinoma ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Propensity Matching

Abstract Background : To investigate whether there is a distinct difference in prognosis between hepatoid adenocarcinoma of the stomach ( HAS) and non-hepatoid adenocarcinoma of the stomach (non-HAS) and whether HAS can benefit from radical surgery. Methods : We retrospectively reviewed 722 patients with non-HAS and 75 patients with HAS who underwent radical gastrectomy between 3 November 2009 and 17 December 2018. Propensity score matching (PSM) analysis was used to eliminate the bias among the patients in our study. The relationships between gastric cancer type and overall survival (OS) were evaluated by the Kaplan-Meier method and Cox regression. Results : Our data demonstrate that there was no statistically significant difference in the OS between HAS and non-HAS {K-M, P=log rank (Mantel-Cox), (before PSM P=0.397); (1:1 PSM P=0.345); (1:2 PSM P=0.195)}. Moreover, there were no significant differences in the 1-, 2-, or 3-year survival rates between patients with non-HAS and patients with HAS (before propensity matching, after 1:1 propensity matching, and after 1:2 propensity matching). Conclusion : HAS was generally considered to be an aggressive gastric neoplasm, but its prognosis may not be as unsatisfactory as previously believed.

scholarly journals Pituitary carcinoma: The University of Texas MD Anderson Cancer Center experience

2018 ◽  
Author(s):  
Fernando Santos-Pinheiro ◽  
Marta Penas-Prado ◽  
Carlos Kamiya-Matsuoka ◽  
Steven G Waguespack ◽  
Anita Mahajan ◽  
...  
Keyword(s):  
Survival Rate ◽  
Disease Control ◽  
Survival Rates ◽  
Pituitary Carcinoma ◽  
Cancer Center ◽  
Ki 67 ◽  
Entire Cohort ◽  
University Of Texas ◽  
Single Center Experience ◽  
Md Anderson

AbstractBackground: Pituitary carcinoma (PC) is an aggressive neuroendocrine tumor diagnosed when a pituitary adenoma (PA) becomes metastatic. PCs are typically resistant to therapy and frequently recur. Recently, treatment with temozolomide (TMZ) has shown promising results, although the lack of prospective trials limits accurate assessment. Methods: We describe a single-center experience in managing PC over a 22-year period and review previously published PC series. Results: 17 patients were identified. Median age at PC diagnosis was 44 years (range 16-82), and the median PA-to-PC conversion time was 5 years (range 1-29). Median follow-up was 28 months (range 8-158) with 7 deaths. Most PC were hormone-positive based on immunohistochemistry (n=12): ACTH (n=5), PRL (n=4), LH/FSH (n=2), GH (n=1). All patients underwent at least one resection and one course of radiation after PC diagnosis. Immunohistochemistry showed high Ki-67 labeling index (>3%) in 10/15 cases. Eight patients (47%) had metastases only to the CNS, and 6 (35%) had combined CNS and systemic metastases. The most commonly used chemotherapy was TMZ, and TMZ-based therapy was associated with the longest period of disease control in 12 (71%) cases, as well as the longest period from PC diagnosis to first progression in 8 (47%) cases. The 2, 3 and 5-year survival rate of the entire cohort was 71%, 59% and 35%, respectively. All patients surviving >5 years were treated with TMZ-based therapy. Conclusions: PC treatment requires a multidisciplinary approach and multimodality therapy including surgery, radiation and chemotherapy. TMZ-based therapy was associated with higher survival rates and longer disease control.PrecisWe describe 17 PC patients who were diagnosed and treated at MDACC over a 22-year period. We have found that TMZ-based therapy correlated with longer disease control and higher survival rate.

scholarly journals Oncologic outcomes comparison of partial ureterectomy and radical nephroureterectomy for urothelial carcinoma

BMC Urology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Shengxian Li ◽  
Yuchen Pan ◽  
Jinghai Hu
Keyword(s):  
Cox Regression ◽  
Oncologic Outcomes ◽  
Radical Nephroureterectomy ◽  
Cancer Specific Survival ◽  
Urothelial Carcinomas ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Function Preservation ◽  
The Mean

Abstract Background The appropriate application of various treatment for upper tract urothelial carcinomas (UTUCs) is the key to prolong the survival of UTUC patients. Herein, we used data in our database to assess the oncological outcomes between partial ureterectomy (PU) and radical nephroureterectomy (RNU). Methods From 2007 to 2014, 255 patients with UTUC undergoing PU or RNU in our hospital database were investigated. Perioperative, postoperative data, and pathologic outcomes were obtained from our database. Cancer-specific survival (CSS) was assessed through the Kaplan-Meier method with Cox regression models to test the effect of these two surgery types. Results The mean length of follow-up was 35.8 months (interquartile range 10–47 months). Patients with high pT stage (pT2–4) suffered shorter survival span (HR: 9.370, 95% CI: 2.956–29.697, P < 0.001). There were no significant differences in CSS between PU and RNU (P = 0.964). In the sub-analysis, CSS for RNU and PU showed no significant difference for pTa–1 or pT2–4 tumor patients (P = 0.516, P = 0.475, respectively). Conclusions PU is not inferior to RNU in oncologic outcomes. Furthermore, PU is generally recognized with less invasive and better renal function preservation compared with RNU. Thus, PU would be rational for specific patients with UTUCs.

scholarly journals RARE-47. CHARACTERIZATION OF ADULT MEDULLOBLASTOMA; A RETROSPECTIVE REVIEW OF 200 PATIENTS AT MD ANDERSON CANCER CENTER

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi231-vi232 ◽  
Author(s):  
Nazanin Majd ◽  
Max Mastall ◽  
Kenneth Hess ◽  
Greg Fuller ◽  
Kristin Alfaro-Munoz ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Distant Recurrence ◽  
Cancer Center ◽  
Adult Medulloblastoma ◽  
Treatment Information ◽  
Significant Difference ◽  
Distinct Disease ◽  
Long Term Follow Up ◽  
First Recurrence ◽  
Md Anderson

Abstract INTRODUCTION Prospective studies for adult medulloblastoma (MB) are scarce and management guidelines are largely derived from pediatric experience and retrospective data. However, adult MB is a distinct disease for which limited data exist regarding clinical characteristic, prognostic factors, outcome based on upfront treatment, or patterns of recurrence. METHODS 200 patients (≥18 years at diagnosis) were identified from 1978 to 2017. Survival analysis was performed using the Kaplan-Meier method. RESULTS Median age at diagnosis 29 (18–63); 111 (55.5%) standard-risk (SR), 59 (29.5%) high-risk (HR), 30 (15%) unknown. 188 (94%) and 97 (48.5%) underwent radiotherapy and upfront chemotherapy, respectively. Median PFS: 6.28 years (4.9–11.2); median OS: 8.8 (7.8–12.4) years. Median time to first recurrence: 8.2 (5.1-not reached); 5-year recurrence-free rate: 71% in SR and 45% in HR patients. Survival after first recurrence: 2 years (1.64–2.4). Documented recurrence and risk group were associated with survival (HR 30.4, p< 0.0001 and 2.33, p< 0.001), but metastatic status and local vs. distant recurrence were not. The effect of upfront chemotherapy on survival did not reach statistical significance in SR patients. The use of chemotherapy regimens with or without vincristine or containing cisplatin vs. carboplatin, did not alter the survival outcome. In a subgroup of 57 SR patients who were seen at initial diagnosis and for whom complete staging and treatment information were available 3 and 5-year PFS were 94% (88%, 100%) and 76% (66%, 86%); OS at 5 years, 94% (87%, 100%). CONCLUSION No statistically significant difference was noted in outcome of patients treated without vincristine or with carboplatin instead of cisplatin, suggesting attenuated upfront regimens could be considered to reduce toxicity. Adult MB patients recur late and have a poor post-recurrence survival, therefore long-term follow-up, development of molecular risk-adjusted upfront treatment, and optimization of rescue treatments are needed.

Assessment of Losartan 50 mg on Survival of Post-Dialysis Euvolemic Hypertensive Patients: Findings from HELD Trial

2019 ◽  
Vol 48 (3) ◽  
pp. 233-242
Author(s):  
Raja Ahsan Aftab ◽  
Amer Hayat Khan ◽  
Azreen Syazril Adnan ◽  
Syed Azhar Syed Sulaiman ◽  
Tahir Mehmood Khan
Keyword(s):  
Cox Regression ◽  
Dialysis Session ◽  
Hypertensive Patients ◽  
Cox Regression Analysis ◽  
Probability Of Survival ◽  
End Point ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Single Blind

Aims and objective: To estimate the effect of losartan 50 mg on survival of post-dialysis euvolemic hypertensive patients. Methodology: A single center, prospective, single-blind randomized trial was conducted to estimate the survival of post-dialysis euvolemic hypertensive patients when treated with lorsartan 50 mg every other day. Post-dialysis euvolemic assessment was done by a body composition monitor. Covariate Adaptive Randomization was used for allocation of participants to the standard or intervention arm, and the follow-up duration was twelve months. The primary end point was achieving targeted blood pressure (BP) of <140/90 mm Hg and maintaining for 4 weeks, whereas secondary end point was all cause of mortality. Pre-, intra-, and post-dialysis session BP measurements were recorded, and survival trends were analyzed using Kaplan-Meier analysis. Results: Of the total 229 patients, 96 (41.9%) were identified as post-dialysis euvolemic hypertensive. Final samples of 88 (40.1%) patients were randomized into standard (n = 44) and intervention arms (n = 44), and 36 (81.8%) patients in each arm completed a follow-up of 12 months. A total of eight patients passed away during the 12-month follow-up period (6 deaths among standard arm and 2 in intervention arm). However, the probability of survival between both arms was not significant (p = 0.13). Cox regression analysis revealed that chances of survival were higher among the patients in the intervention (OR 3.17) arm than the standard arm (OR 0.31); however, the survival was found not statistically significant. Conclusion: There was no statistical significant difference in 1 year survival of post-dialysis euvolemic hypertensive patients when treated with losartan 50 mg.

Pancreas cancer: Influence of gender and other demographic and clinical parameters on survival.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12529-e12529 ◽  
Author(s):  
Patricia Renee Blank ◽  
Thomas D. Szucs
Keyword(s):  
Pancreatic Cancer ◽  
Gender Difference ◽  
Pancreas Cancer ◽  
Cox Regression ◽  
Total Sample ◽  
Cancer Prognosis ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Cox Proportional Hazard Models

e12529 Background: Research suggests that lower excess mortality risk for females compared to men do exist for several cancer types. The primary aim of this study was to investigate whether gender affects pancreatic cancer prognosis. In addition, the relationship of sex and survival adjusted for clinical and demographic factors was assessed. Methods: The Surveillance, Epidemiology, and End Results (SEER) database (version 1973-2009) was used to identify patients with primary histological confirmed pancreas cancer (≥18 years, 80,689 males and 82,356 females). The analysis was stratified by five different stages (in situ, locally invasive, regional, distant, unstaged). The crude effect of gender was assessed in the total sample and in age-stratified Kaplan-Meier Curves (<55 years) in all five stages, respectively. Univariate and multivariate Cox proportional hazard models were run within the local stage. The predictors included in the models were demographic and clinical factors. P-values (2-sided) of 0.05 were assumed as statistical significant. Results: Between 1973 and 2009, 128,645 pancreas cancer-related deaths were reported. The median follow-up time of the censored patients was 13 months. The Kaplan-Meier curves showed a significant difference in survival among men and female in the locally invasive group (median survival in male and female: 7 months; 1-year survival: 35.5% and 35.1% among female and men, respectively; Log-Rank: p=0.0072). Of the remaining strata, all others had non-significant differences, except the unstaged group (Log-Rank: p= <.0001). The univariate Cox-regression indicated a 5.6% (95%CI: 1.4%, 9.9%, p=0.0081) higher rate of dying among men compared to female (local recurrence). Among the younger population (<55 years), the gender difference was significant across all disease stages, except the in situ group. Histology grade, age, race, and marital status was associated with survival from pancreatic cancer in the multivariate analysis. Conclusions: The present study indicates a gender difference in survival among pancreas cancer patients. The study findings are, however, preliminary and hypothesis generating and a matter for further investigation to give a distinct conclusion.

Do patients with cardiovascular diseases have earlier relapse in stage I-III non-small cell lung cancer?

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9603-9603
Author(s):  
Robert M. Crescentini ◽  
Richard R. Reich ◽  
Pooja Bardhan ◽  
Martine Extermann
Keyword(s):  
Cerebrovascular Disease ◽  
Cox Regression ◽  
Early Stage ◽  
Antihypertensive Agents ◽  
Disease Free Survival ◽  
Stage I ◽  
Cancer Center ◽  
Bivariate Analysis ◽  
Early Stage Disease ◽  
Kaplan Meier

9603 Background: Diabetes mellitus (DM) has been reported to be an independent risk factor in the development of recurrence of NSCLC following treatment of early stage disease. We evaluated to see if there was a similar effect of cardiovascular disease in patients with newly diagnosed NSCLC. Methods: Using the Moffitt Cancer Center (MCC) databases, patients were identified who were treated for stage I, II and III NSCLC at MCC from 2001-2003. Charts were reviewed and descriptive data were recorded including histories of DM, coronary artery disease (CAD), hypertension, cerebrovascular disease and congestive heart failure (CHF). The use of aspirin and antihypertensive agents at the time of diagnosis were also recorded. Primary endpoint was disease free survival (DFS). Overall survival (OS) was a secondary endpoint. Kaplan Meier curves and Cox regression analyses were used for DFS and OS. Results: A total of707 patients were identified. Ninety-seven patients had DM, 158 had CAD, 396 had hypertension, 43 had cerebrovascular disease and 56 had CHF. DFS was worse in patients with DM (p<0.001, OR 0.63, 95% CI 0.50-0.80), CAD (p<0.001, OR 0.70, 95% CI 0.57-0.85), hypertension (p=0.016, OR 0.81, 95% CI 0.67-0.96), cerebrovascular disease (p=0.006, OR 0.62, 95% CI 0.45-0.87) and CHF (p<0.001, OR 0.56, 95% CI 0.42-0.75). Bivariate analysis showed that CAD, cerebrovascular disease and CHF were associated with shorter DFS independent of DM. OS was also worse in patients with DM (p<0.001, 95% CI 0.50-0.81), CAD (p<0.001, OR 0.62, 95% CI 0.51-0.78), hypertension (p=0.004, OR 0.77, 95% CI 0.64-0.92), cerebrovascular disease (p=0.02, OR 0.66, 95% CI 0.47-0.94) and CHF (p<0.001, OR 0.54, 95% CI 0.41-0.73). In patients with hypertension, there was an improvement in DFS (p=0.047, OR 1.35, 95% CI 1.004-1.819) for those treated with thiazide diuretics. There were no other statistically significant differences in patients based on antihypertensive regimens or aspirin use. Conclusions: DM,CAD, hypertension, cerebrovascular disease and CHF are associated with shorter DFS and worse overall prognosis in patients with non-metastatic NSCLC. CAD, cerebrovascular disease and CHF are associated with shorter DFS independent of DM.

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