Long-term outcomes of esophageal and gastric cancer patients with cardiovascular and metabolic diseases: A two-center propensity score-matched cohort study

Bo Zhou; Zhixin Wang; Qifeng Dou; Wenbin Li; Yangyang Li; Zhengqiang Yan; Peisheng Sun; Baosheng Zhao; Xiumin Li; Fangfang Shen; Bangjie Zhang; Mingzhou Guo

doi:10.2478/jtim-2023-0112

Long-term outcomes of esophageal and gastric cancer patients with cardiovascular and metabolic diseases: A two-center propensity score-matched cohort study

J Transl Int Med. 2023 Sep 2;11(3):234-245. doi: 10.2478/jtim-2023-0112. eCollection 2023 Sep.

Authors

Bo Zhou¹, Zhixin Wang², Qifeng Dou³, Wenbin Li⁴, Yangyang Li⁵, Zhengqiang Yan⁶, Peisheng Sun⁶, Baosheng Zhao⁷, Xiumin Li^{2

8}, Fangfang Shen⁹, Bangjie Zhang², Mingzhou Guo^{1

2}

Affiliations

¹ Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China.
² Department of Gastroenterology and Hepatology, the First Medical Center, The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang 453003, Henan Province, China.
³ Department of Urology Surgery, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453199, Henan Province, China.
⁴ Department of Cardiovascular Surgery, Beijing Anzhen Hospital affiliated to Capital Medical University, Beijing 100029, China.
⁵ Department of Cardiovascular Surgery, Henan Provincial Chest Hospital, Zhengzhou 450008, Henan Province, China.
⁶ Department of General Surgery, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453199, Henan Province, China.
⁷ Department of Thoracic Surgery, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453199, Henan Province, China.
⁸ Henan Key Laboratory of Tumor Molecular Therapy Medicine, Xinxiang Medical University, Xinxiang 453003, Henan Province, China.
⁹ The Key Laboratory for Tumor Translational Medicine, The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang 453003, Henan Province, China.

Abstract

Background and objectives: An increased risk of cardiovascular and metabolic diseases (CVMDs) among patients with cancer suggests a potential link between CVMD and cancer. The impact of CVMD on the survival time of patients with esophageal and gastric cancer remains unknown. We aimed to determine the incidence of CVMD and its impact on the longterm outcomes in esophageal and gastric cancer patients.

Methods: A total of 2074 cancer patients were enrolled from January 1, 2007 to December 31, 2017 in two hospitals, including 1205 cases of esophageal cancer and 869 cases of gastric cancer, who were followed up for a median of 79.8 and 79.3 months, respectively. Survival time was analyzed using the Kaplan-Meier method before and after propensity score matching.

Results: The incidence of CVMD in patients with esophageal and gastric cancer was 34.1% (411/1205) and 34.3% (298/869), respectively. The effects of hypertension, diabetes, and stroke on the long-term survival of esophageal and gastric cancer patients were not significant (all P > 0.05). The survival time was significantly longer in esophageal cancer patients without ischemic heart disease than in patients with ischemic heart disease, both before matching (36.5 vs. 29.1 months, P = 0.027) and after matching (37.4 vs. 27.9 months, P = 0.011). The survival time in gastric cancer patients without ischemic heart disease was significantly longer than in patients with ischemic heart disease, both before (28.4 vs.17.5 months, P = 0.032) and after matching (29.5 vs.17.5 months, P = 0.02).

Conclusion: The survival time of esophageal and gastric cancer patients with ischemic heart disease was significantly reduced compared to that of esophageal and gastric cancer patients without ischemic heart disease.

Keywords: cardiovascular and metabolic diseases; esophageal cancer; gastric cancer; long-term outcome; propensity score matching.

© 2023 Bo Zhou, Zhixin Wang, Qifeng Dou, Wenbin Li, Yangyang Li, Zhengqiang Yan, Peisheng Sun, Baosheng Zhao, Xiumin Li, Fangfang Shen, Bangjie Zhang, Mingzhou Guo, published by De Gruyter on behalf of Scholar Media Publishing.