Risk factors associated with a second primary lung cancer (SPLC) in patients (pts) with a previous initial primary lung cancer (IPLC).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13166-e13166
Author(s):  
Misako Nagasaka ◽  
Dina Farhat ◽  
Kimberly Belzer ◽  
Seongho Kim ◽  
Hirva Mamdani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Family History ◽  
Surgical Resection ◽  
Tobacco Use ◽  
Primary Lung Cancer ◽  
Smoking History ◽  
Factors Associated ◽  
Increased Risk ◽  
First Diagnosis

e13166 Background: The risk for development of a SPLC after treatment of an IPLC is around 1% to 2% per pt per year. The aim of this study was to characterize the risk factors associated with the development of a SPLC. Methods: Pts registered in the Karmanos Cancer Institute Tumor Registry diagnosed with an IPLC between 2000 and 2017 were included in this study. Pts with an IPLC who later developed a SPLC were matched for age, histology and stage to pts with an IPLC who did not develop a SPLC. SPLC was defined as a second lung cancer with a different pathology or if the same pathology, anatomically, molecularly, or chronologically distinct. Six variables including: stage at IPLC, histology, family history, surgery as a primary treatment for IPLC, and smoking history (determined by pack years, and continued tobacco use after first diagnosis) were reviewed. Logistic and Cox regression analyses were performed to determine the relationship of these characteristics with the development of a SPLC, and their association with overall survival (OS). Results: 121 pts with IPLC who later developed an SPLC were identified and compared to 120 pts with IPLC who did not develop a SPLC. Logistic analyses did not show that stage at first diagnosis, histology, family history, smoking history, and continued tobacco use after first diagnosis to be relevant for increased risk of SPLC. Pts who were primarily treated with surgical resection had a significantly higher probability of developing a SPLC (Odds Ratio: 0.24, 95% CI: 0.12 to 0.48, p < 0.001). Pts who did not have surgical resection as their primary mode of treatment for IPLC had a significantly higher risk of death than those who received surgical resection (HR 3.02, 95% CI: 1.99 to 4.57; p < 0.001). Conclusions: Based on our findings, pts who had surgical resection for an IPLC were found to have improved OS and a higher possibility of developing a SPLC. Stage at first diagnosis of IPLC, histology, family history, smoking history and continued use of tobacco after first diagnosis did not correlate with increased risk for SPLC. These results warrant further investigation and if confirmed could have an impact on surveillance recommendations post resection of initial lung cancers.

Tobacco Use Is Associated with More Severe Adverse Outcomes Than Morbid Obesity after Aseptic Revision TKA

2021 ◽  
Author(s):  
Michael P. Hagerty ◽  
Rafael Walker-Santiago ◽  
Jason D. Tegethoff ◽  
Benjamin M. Stronach ◽  
James A. Keeney
Keyword(s):  
Risk Factors ◽  
Morbid Obesity ◽  
Tobacco Use ◽  
Adverse Outcomes ◽  
Smoking History ◽  
Morbidly Obese ◽  
Knee Amputation ◽  
Increased Risk ◽  
Aseptic Revision ◽  
Component Revision

AbstractThe association of morbid obesity with increased revision total knee arthroplasty (rTKA) complications is potentially confounded by concurrent risk factors. This study was performed to evaluate whether morbid obesity was more strongly associated with adverse aseptic rTKA outcomes than diabetes or tobacco use history—when present as a solitary major risk factor. Demographic characteristics, surgical indications, and adverse outcomes (reoperation, revision, infection, and amputation) were compared between 270 index aseptic rTKA performed for patients with morbid obesity (n = 73), diabetes (n = 72), or tobacco use (n = 125) and 239 “healthy” controls without these risk factors at a mean 75.7 (range: 24–111) months. There was no difference in 2-year reoperation rate (17.8 vs. 17.6%, p = 1.0) or component revision rate (8.2 vs. 8.4%) between morbidly obese and healthy patients. However, higher reoperation rates were noted in patients with diabetes (p = 0.02) and tobacco use history (p < 0.01), including higher infection (p < 0.05) and above knee amputation (p < 0.01) rates in patients with tobacco use history. Multivariate analysis retained an independent association between smoking history and amputation risk (odds ratio: 7.4, 95% confidence interval: 1.7–55.2, p < 0.01). Morbid obesity was not associated with an increased risk of reoperation or component revision compared with healthy patients undergoing aseptic revision. Tobacco use was associated with increased reoperation and above knee amputation. Additional study will be beneficial to determine whether risk reduction efforts are effective in mitigating postoperative complication risks.

Impact of Young Age on the Presentation of Saccular Intracranial Aneurysms: Population-Based Analysis of 4082 Patients

Neurosurgery ◽  
2017 ◽  
Vol 82 (6) ◽  
pp. 815-823 ◽  
Author(s):  
Sari Räisänen ◽  
Juhana Frösen ◽  
Mitja I Kurki ◽  
Terhi Huttunen ◽  
Jukka Huttunen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Intracranial Aneurysms ◽  
De Novo ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Population Based ◽  
Young Age ◽  
Smoking History ◽  
Old Patients ◽  
First Diagnosis

Abstract BACKGROUND Formation and rupture of saccular intracranial aneurysms (sIAs) may have different pathobiologies in patients with younger age at first diagnosis of sIA disease. OBJECTIVE To study the phenotype of sIA disease and formation of new (de novo) sIAs in patients below 40 yr. METHODS A population-based cohort study was conducted in 613 young (&lt;40 yr) sIA patients with first diagnosis between 1980 and 2014 and total angiographic follow-up of 3768 yr. RESULTS Of the 613 sIA patients &lt;40 yr, 508 had aneurysmal subarachnoid hemorrhage (sIA-SAH) and 105 unruptured sIA(s) at first sIA diagnosis. Hypertension was 2 times less common among &lt;40 than &gt;40-yr-old patients (unruptured and ruptured). Smoking was very prevalent in &lt;40-yr-old patients (33% in SAH, 68% unruptured). SAH patients &lt;40 yr more often had family history of sIA, and lower PHASES scores (age omitted, P &lt; .001). Ruptured sIAs were small (&lt;7 mm) in 33% of 39 to 30 yr patients, in 44% of 29 to 20 yr patients, and 57% of &lt;19 yr patients. Their shape was irregular in 90%, 94%, and 95%, respectively. Smoking history (hazard ratio [HR] 2.8, 95% confidence interval [CI] 1.2-7.0), family history for sIAs (HR 3.1, 95% CI 1.3-7.7), and age at presentation (HR .91 per year, 95% CI .85-.98) were risk factors for de novo sIA formation, diagnosed in 4% even after 20 yr (median 11.8 yr). CONCLUSION Smoking and family history are risk factors for sIA formation and aneurysmal SAH at young age. Young aneurysmal SAH patients had lower PHASES scores and often rupture from a small sIA, suggesting need for more aggressive management.

Inhaled corticosteroid use and risk of pneumonitis in patients treated with immune checkpoint inhibitors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 3140-3140
Author(s):  
Mingjia Li ◽  
Daniel Spakowicz ◽  
Songzhu Zhao ◽  
Sandip H. Patel ◽  
Andrew Johns ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Inhaled Corticosteroids ◽  
Checkpoint Inhibitors ◽  
Performance Status ◽  
Smoking History ◽  
Inhaled Corticosteroid ◽  
Significance Threshold ◽  
Inflammatory Status ◽  
Increased Risk

3140 Background: The identification of risk factors for immune-related adverse events (irAEs) is an important area of research. Among irAEs, pneumonitis carries one of the highest morbidities. There is a lack of strong predictors for pneumonitis in patients (pts) treated with ICI. We sought to identify predictors for the development of pneumonitis, and whether the use of inhaled corticosteroids (ICS) at time of ICI could be protective. Methods: Pts with advanced cancer treated with ICI from 2011 and 2018 were included in this retrospective study. Pneumonitis attribution to ICI was determined by treating physician at time of diagnosis. Time to pneumonitis was defined as days from the start of ICI to pneumonitis diagnosis. Pts who never had pneumonitis were censored at the time of last follow up or death. Predictors of pneumonitis were assessed by univariate Cox proportional hazard models at a significance threshold of alpha = 0.05. Results: A total of 837 pts were identified, and 30 (3.6%) pts developed any grade pneumonitis (12 grade 2, 14 grade 3, 1 grade 4, 3 grade 5) after receiving ICI (Table). Pts with age ≥65 years (y) had increased risk of developing pneumonitis over pts with age < 65y (HR 2.1, 95 CI: 1.02-4.4, p=0.041). 82 (9.7%) of the total cohort were on inhaled corticosteroid (ICS) at time of ICI, and 9 (11%) developed pneumonitis. Rather than being protective, pts on ICS had higher risk of pneumonitis (HR 4.2, 95 CI: 1.9-9.2, p=0.001). Pts with lung cancer had an increased risk for pneumonitis compared to pts with other cancers (HR 3.2, 95 CI: 1.5-6.4, p =0.003). Other risk factors included performance status, smoking history, line of therapy, or prior treatment including radiation were not statistically significant. Conclusions: Rather than a protective effect of ICS, our analysis found a higher risk of pneumonitis in pts treated with ICS. We confirmed an increased risk of pneumonitis for lung cancer pts compared to pts with other cancers, and higher risk of pneumonitis in pts age >65y. We hypothesize that the increased inflammatory status in chronic lung inflammation may predispose pts to pneumonitis that was not ameliorated by ICS. Future study is needed in prospective cohorts to further clarify the underlying inflammatory mechanism. [Table: see text]

scholarly journals Likely Uptake of a Future a Lung Cancer Screening Programme in Hodgkin Lymphoma Survivors: a Questionnaire Study

2021 ◽  
Author(s):  
Rachel Broadbent ◽  
Christopher J. Armitage ◽  
Philip Crosbie ◽  
John Radford ◽  
Kim Linton
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Hodgkin Lymphoma ◽  
Multivariable Analysis ◽  
Lung Cancer Screening ◽  
Smoking History ◽  
Malignant Neoplasms ◽  
Heavy Smoking ◽  
Factors Associated ◽  
Increased Risk

Abstract Background Many Hodgkin lymphoma (HL) survivors are at increased risk of subsequent malignant neoplasms (SMN), including lung cancer, due to previous treatment for HL. Lung cancer screening (LCS) detects early-stage lung cancers in ever smokers but HL survivors without a heavy smoking history are ineligible for screening. There is a rationale to develop a targeted LCS. The aim of this study was to investigate levels of willingness to undergo LCS in HL survivors, and to identify the psycho-social factors associated with screening hesitancy. Methods A postal questionnaire was sent to 281 HL survivors registered in a long-term follow-up database and at increased risk of SMNs. Demographic, lung cancer risk factors, psycho-social and LCS belief variables were measured. Multivariable logistic regression analysis was performed to determine the factors associated with lung cancer screening hesitancy, defined as those who would ‘probably’ or ‘probably not’ participate. Results The response rate to the questionnaire was 58% (n=165). Participants were more likely to be female, older and living in a less deprived area than non-participants. Uptake (at any time) of breast and bowel cancer screening among those previously invited was 99% and 77% respectively. 159 participants were at excess risk of lung cancer. The following results refer to these 159. Around half perceived themselves to be at greater risk of lung cancer than their peers. Only 6% were eligible for lung cancer screening pilots aimed at ever smokers in the UK. 98% indicated they would probably or definitely participate in LCS were it available. Psycho-social variables associated with LCS hesitancy on multivariable analysis were male gender (OR 5.94 CI 1.64-21.44, p<0.01), living in an area with a high index of multiple deprivation (IMD) decile (deciles 6-10) (OR 8.22 CI 1.59-42.58, p<0.05) and lower levels of self-efficacy (OR 1.64 CI 1.30-2.08 p<0.01). Conclusion HL survivors responding to this survey were willing to participate in a future LCS programme but there was some hesitancy. A future LCS trial for HL survivors should consider the factors associated with screening hesitancy in in order to minimise barriers to participation.

Scaphotrapeziotrapezoid Arthrodesis: A 10-Year Follow-up Study of Complications in 58 Wrists

Hand ◽  
2020 ◽  
pp. 155894472096497
Author(s):  
Miranda J. Rogers ◽  
Chao-Chin Lu ◽  
Andrew R. Stephens ◽  
Brittany N. Garcia ◽  
Wei Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Smoking History ◽  
Fixation Method ◽  
Veterans Health ◽  
Health Administration ◽  
Opioid Use ◽  
Factors Associated ◽  
Increased Risk ◽  
Stt Arthrodesis

Background: Scaphotrapeziotrapezoid (STT) arthrodesis is a procedure used for specific degenerative arthritis and instability patterns of the wrist. This study evaluates nonunion rate and risk factors for reoperation after STT arthrodesis in the Veterans Affairs Department patient population. The purpose of our study was to assess the long-term nonunion rate following STT arthrodesis and to identify factors associated with reoperation. Methods: The national Veterans Health Administration Corporate Data Warehouse and Current Procedural Terminology codes identified STT arthrodesis procedures from 1995 to 2016. Frequencies of total wrist arthrodesis (TWA) and secondary operations were determined. Univariate analyses provided odds ratios for risk factors associated with complications. Results: Fifty-eight STT arthrodeses were performed in 54 patients with a mean follow-up of 120 months. Kirschner wires (K-wires) were the most common fixation method (69%). Six wrists (10%) required secondary procedures: 5 TWAs and 1 revision STT arthrodesis. Four patients underwent additional procedures for nonunion (7%). Twenty-four patients required K-wire removal, 8 (14%) of these in the operating room, which were not included in regression analysis. Every increase in 1 year of age resulted in a 15% decrease in likelihood of reoperation (95% confidence interval: 0.77-0.93; P < .0001). Opioid use within 90 days before surgery ( P = 1.00), positive smoking history ( P = 1.00), race ( P = .30), comorbidity count ( P = .25), and body mass index ( P = .19) were not associated with increased risk of reoperation. Conclusions: At a mean follow-up of 10 years, patients undergoing STT arthrodesis have a 10% risk of reoperation, and this risk decreases with older patient age. There was a symptomatic nonunion rate of 7%, similar to prior published rates. Patient demographics, comorbidity, smoking history, and opioid use did not appear to increase risk of reoperation.

Second primary lung cancer following laryngeal cancer: retrospective study of incidence and multivariate analysis of risk factors in 209 patients

2019 ◽  
Vol 133 (11) ◽  
pp. 974-979 ◽  
Author(s):  
M Adams ◽  
G Gray ◽  
A Kelly ◽  
F Toner ◽  
R Ullah
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Laryngeal Cancer ◽  
Primary Lung Cancer ◽  
Case Series ◽  
Hazard Ratio ◽  
Second Primary ◽  
Second Primary Lung Cancer ◽  
Increased Risk ◽  
Computed Tomography Scanning

AbstractObjectiveTo analyse the incidence of second primary lung cancer following treatment for laryngeal cancer and to identify risk factors for its development.MethodRetrospective case series.ResultsThe five-year actuarial incidence of second primary lung cancer was 8 per cent (1.6 per cent per year). This was associated with a very poor median survival of seven months following diagnosis. Supraglottic tumours were associated with an increased risk of second primary lung cancer compared to glottic tumours in both univariate (hazard ratio = 4.32, p = 0.005) and multivariate analyses (hazard ratio = 4.14, p = 0.03).ConclusionSecond primary lung cancer occurs at a rate of 1.6 per cent per year following a diagnosis of laryngeal cancer, and this is associated in a statistically significant manner with supraglottic primary tumour. The recent National Lung Cancer Screening Trial suggests a survival advantage of 20 per cent at five years with annual screening using low-dose computed tomography scanning of the chest in a comparable cohort to ours. These findings have the potential to inform post-treatment surveillance protocols in the future.

Smoking history predicts for increased risk of second primary lung cancer: A comprehensive analysis

Cancer ◽  
2014 ◽  
Vol 121 (4) ◽  
pp. 598-604 ◽  
Author(s):  
John M. Boyle ◽  
Daniel J. Tandberg ◽  
Junzo P. Chino ◽  
Thomas A. D'Amico ◽  
Neal E. Ready ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Primary Lung Cancer ◽  
Comprehensive Analysis ◽  
Smoking History ◽  
Second Primary ◽  
Second Primary Lung Cancer ◽  
Increased Risk

scholarly journals Chronic Progression of Lung Cancer Recurrence After Surgery: Warning Role of Postoperative Pneumonia

2021 ◽  
Author(s):  
Dong-qi Lin ◽  
Jin-guo Zhu ◽  
Xiao-hua Xu ◽  
Ke Xiao ◽  
Xu-qing Wen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Primary Lung Cancer ◽  
Lung Cancer Surgery ◽  
Cancer Recurrence ◽  
Postoperative Pneumonia ◽  
Post Surgery ◽  
Increased Risk

Abstract Background: The association between the process of postoperative pneumonia and lung cancer recurrence remains elusive in lung cancer surgery. We investigated the association between postoperative pneumonia and lung cancer recurrence development, emphasizing the warning role of postoperative specific pneumonia, in primary lung cancer resection patients.Methods: We assessed the occurrence of postoperative pneumonia in four to six months (PPFS), seven to twelve month (PPST), and lung cancer recurrence within one year (LRO) in 332 patients. The primary outcome was the development of PPST and LRO according to PPFS occurrence. Relevant risk factors of PPFS, PPST and LRO were identified through multivariable regression analysis.Results: During follow-up, 151 participants (45.48%) experienced PPFS outcomes. Regardless of the existing of postoperative pneumonia in one to three months (PPOT), PPFS increased the risk of PPST (OR: 2.886, 95% CI: 1.193-6.978, P<0.01 and LRO (OR: 2.793, 95% CI: 1.406- 5.552, P<0.01), and persistent PPST further increased the risk of LRO (OR:16.271, 95% CI: 6.757-39.182, P<0.001). Generalized estimating equation identified chemotherapy or targeted therapy as independent risk factors for PPFS and PPST.Conclusions: PPFS was associated with increased risk of PPST and LRO. Postoperative pulmonary inflammation assessed 4 months post-surgery also significantly influenced LRO development, indicating a need for close follow-up of lung inflammatory conditions to improve patient outcomes.

scholarly journals Risk Factors Associated with the Occurrence of Autoimmune Diseases in Adult Coeliac Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Laura Conti ◽  
Edith Lahner ◽  
Gloria Galli ◽  
Gianluca Esposito ◽  
Marilia Carabotti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Autoimmune Diseases ◽  
Type I Diabetes ◽  
Type I ◽  
Factors Associated ◽  
Specific Risk ◽  
Increased Risk ◽  
History Of ◽  
Control Study

Objectives. Autoimmune diseases (AD) may be associated with coeliac disease (CD), but specific risk factors have been poorly investigated. The aim of this study was to assess the spectrum of AD and its specific risk factors associated in a series of adult coeliac patients. Materials and Methods. We performed a single-center case-control study including adult newly diagnosed CD patients. To evaluate the risk factors of the association between AD and CD, 341 coeliac patients included were categorized on the basis of AD presence: 91 cases with at least one AD and 250 controls without AD were compared for clinical, serological, and histological features. Eighty-seven cases were age-gender-matched with 87 controls. Results. Among 341 CD patients, 26.6% of CD patients had at least one AD. Endocrine and dermatological diseases were the most prevalent AD encountered: autoimmune thyroiditis was present in 48.4% of cases, psoriasis in 17.6%, and type I diabetes and dermatitis herpetiformis in 11%, respectively. At logistic regression, factors associated with AD were a positive 1st-degree family history of AD (OR 3.7, 95% CI 1.93–7), a body mass index ≥ 25 kg/m2 at CD diagnosis (OR 2.95%, CI 1.1–3.8), and long standing presentation signs/symptoms before CD diagnosis (>10 years) (OR 2.1, 95% CI 1.1–3.7). Analysis on age-gender-matched patients confirmed these results. Conclusions. CD patients with family history of AD, overweight at CD diagnosis, and a delay of CD diagnosis had an increased risk of having another AD. The benefit of CD screening in these specific subsets of patients with AD awaits further investigation.

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