Impact of Smoking-Related Chronic Obstruction Pulmonary Disease on Mortality of Invasive Ductal Carcinoma Patients Receiving Standard Treatments: Propensity Score-Matched, Nationwide, Population-Based Cohort Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Patients and Methods
2.1. Study Population
2.2. Inclusion and Exclusion Criteria
2.3. Propensity Score Matching and Covariates
2.4. Statistics
3. Results
3.1. Propensity Score Matching and Study Cohort
3.2. Prognostic Factors of All-Cause Mortality after Multivariate Cox Regression Analyses
3.3. Kaplan–Meier OS among Non-COPD, COPD, and Hospitalization for COPDAE
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
COPD | Chronic Obstructive Pulmonary Disease |
IDC | Invasive Ductal Carcinoma |
COPDAE | COPD with Acute Exacerbation |
aHR | Adjusted Hazard Ratio |
CI | Confidence Interval |
MACE | Major Adverse Cardiac Events |
AJCC | American Joint Committee on Cancer |
RILI | Radiation-Induced Lung Injury |
RP | Radiation Pneumonitis |
TCRD | Taiwan Cancer Registry Database |
PSM | Propensity Score Matching |
SD | Standard Deviation |
AJCC | American Joint Committee on Cancer |
HR | Hormone Receptor |
Her-2 | Human Epidermal Growth Factor Receptor-2 |
OS | Overall Survival |
SLNB | Sentinel Lymph Node Biopsy |
ALND | Axillary Lymph Node Dissection |
CKD | Chronic Kidney Disease |
CCI | Charlson Comorbidity Index |
ICD-10-CM | International Classification of Diseases, 10th Revision, Clinical Modification |
NCCN | National Comprehensive Cancer Network |
GOLD | Global Initiative for Chronic Obstructive Lung Disease |
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Variables | Nonsmokers without COPD | Smokers with COPD | p-Value | ||
---|---|---|---|---|---|
N = 1546 | N = 773 | ||||
N, % | N, % | ||||
Age (mean ± SD) | (58.37 ± 12.59) | (58.83 ± 12.37) | 0.404 | ||
Age (years) | 0.467 | ||||
≤50 | 396 | 25.61% | 209 | 27.04% | |
51–60 | 444 | 28.72% | 212 | 27.43% | |
61–70 | 414 | 26.78% | 191 | 24.71% | |
>70 | 292 | 18.89% | 161 | 20.83% | |
CCI score | 0.310 | ||||
0 | 1417 | 91.66% | 694 | 89.78% | |
1 | 30 | 1.94% | 20 | 2.59% | |
≥2 | 99 | 6.40% | 59 | 7.63% | |
CCI score (mean ± SD) | (0.16 ± 0.59) | (0.21 ± 0.70) | 0.108 | ||
Menopausal status | 0.320 | ||||
Postmenopausal | 996 | 64.42% | 462 | 59.77% | |
Premenopausal | 550 | 35.58% | 311 | 40.23% | |
Her2 status | 0.422 | ||||
Negative | 1259 | 81.44% | 618 | 79.95% | |
Positive | 287 | 18.56% | 155 | 20.05% | |
Nodal surgery | 0.891 | ||||
SLNB | 1082 | 69.99% | 543 | 70.25% | |
ALND | 464 | 30.01% | 230 | 29.75% | |
AJCC clinical stage | 0.782 | ||||
I | 801 | 51.81% | 408 | 52.78% | |
II | 376 | 24.32% | 193 | 24.97% | |
III | 369 | 23.87% | 172 | 22.25% | |
Hormone receptor | 0.792 | ||||
Negative | 345 | 22.32% | 177 | 22.90% | |
Positive | 1201 | 77.68% | 596 | 77.10% | |
Breast surgery | 0.726 | ||||
Total mastectomy | 228 | 14.75% | 119 | 15.39% | |
Breast-conserving surgery | 1318 | 85.25% | 654 | 84.61% | |
Differentiation | 0.692 | ||||
I | 228 | 14.75% | 119 | 15.39% | |
II | 731 | 47.28% | 351 | 45.41% | |
III | 587 | 37.97% | 303 | 39.20% | |
Adjuvant chemotherapy | 0.177 | ||||
No | 756 | 48.90% | 403 | 52.13% | |
Yes | 790 | 51.10% | 370 | 47.87% | |
Adjuvant radiotherapy | 0.812 | ||||
No | 228 | 14.75% | 119 | 15.39% | |
Yes | 1318 | 85.25% | 654 | 84.61% | |
MACE history | 0.322 | ||||
No | 1114 | 72.06% | 541 | 69.99% | |
Yes | 432 | 27.94% | 232 | 30.01% | |
Hyperlipidemia | 0.566 | ||||
No | 1138 | 78.16% | 589 | 76.20% | |
Yes | 318 | 21.84% | 184 | 23.80% | |
Hypertension | 0.664 | ||||
No | 965 | 66.28% | 502 | 64.94% | |
Yes | 491 | 33.72% | 271 | 35.06% | |
Diabetes | 0.645 | ||||
No | 1164 | 79.95% | 610 | 78.91% | |
Yes | 292 | 20.05% | 163 | 21.09% | |
Chronic kidney disease | 1.000 | ||||
No | 1441 | 98.97% | 765 | 98.97% | |
Yes | 15 | 1.03% | 8 | 1.03% | |
Alcohol use | 0.492 | ||||
No | 1268 | 82.02% | 618 | 79.94% | |
Yes | 278 | 17.98% | 155 | 20.06% | |
Drug abuse | 0.284 | ||||
No | 1500 | 97.02% | 743 | 96.12% | |
Yes | 46 | 2.98% | 30 | 3.88% | |
Frequency of hospitalization for COPDAE within 1 year before breast surgery | <0.001 | ||||
0 | 1546 | 100.00% | 702 | 90.82% | |
1 | 0 | 0.00% | 39 | 5.05% | |
≥2 | 0 | 0.00% | 32 | 4.14% | |
Follow-up (All-cause mortality) Years, Median (IQR, Q1–Q3) | 7.21 (3.53–12.06) | 5.79 (2.59–9.81) | <0.001 | ||
Follow-up (Did not die) Years, Median (IQR, Q1–Q3) | 5.41 (3.49–11.93) | 5.15 (2.56–9.71) | 0.788 |
Variables | Crude HR (95% CI) | Adjusted HR * (95% CI) | p-Value | ||
---|---|---|---|---|---|
COPD status (ref: non-COPD) | |||||
COPD | 1.07 | (0.88–1.31) | 1.04 | (0.83–1.22) | 0.782 |
Frequency of hospitalization for COPDAE within 1 year before breast surgery (ref: 0) | |||||
≥1 | 2.86 | (1.78–3.54) | 1.51 | (1.18–2.36) | 0.002 |
Age (years, ref: ≤50) | |||||
51–60 | 1.71 | (1.23–2.31) | 1.54 | (1.12–2.13) | 0.004 |
61–70 | 2.51 | (1.85–3.39) | 2.32 | (1.67–3.21) | <0.001 |
>70 | 4.81 | (3.61–6.48) | 4.92 | (3.50–6.90) | <0.001 |
CCI score (ref: 0) | |||||
1 | 2.87 | (1.81–4.55) | 1.52 | (1.24–2.12) | <0.001 |
≥2 | 2.55 | (1.88–3.48) | 1.85 | (1.26–2.70) | <0.001 |
Menopausal status (ref: Postmenopausal) | |||||
Premenopausal | 1.38 | (1.08–1.75) | 1.00 | (0.60–1.04) | 0.126 |
HER2 (ref: Negative) | |||||
Positive | 1.51 | (1.18–1.93) | 0.89 | (0.66–1.19) | 0.508 |
Breast surgery (ref: Total mastectomy) | |||||
Breast-conserving surgery | 1.31 | (0.86–1.68) | 1.11 | (0.88–1.20) | 0.382 |
Nodal surgery (ref: SLND) | |||||
ALND | 1.28 | (0.50–1.48) | 1.18 | (0.68–1.87) | 0.492 |
AJCC clinical stage (ref. stage I) | |||||
Stage II | 1.81 | (1.23–2.48) | 1.22 | (1.06–1.93) | 0.003 |
Stage III | 2.13 | (1.60–2.83) | 1.47 | (1.13–1.85) | 0.008 |
Hormone receptor (ref. Negative) | |||||
Positive | 0.92 | (0.81–1.40) | 0.90 | (0.87–1.37) | 0.337 |
Differentiation (ref: Grade I) | |||||
Grade II | 1.08 | (1.02–1.36) | 1.03 | (1.01–1.47) | 0.044 |
Grade III | 1.12 | (1.04–1.38) | 1.08 | (1.07–1.35) | 0.013 |
Adjuvant chemotherapy (ref: No) | |||||
Yes | 0.73 | (0.43–1.10) | 0.83 | (0.72–1.06) | 0.361 |
Adjuvant radiotherapy (ref: No) | |||||
Yes | 0.77 | (0.46–1.13) | 0.70 | (0.52–1.09) | 0.304 |
MACE history (ref: No) | |||||
Yes | 1.16 | (1.01–2.57) | 1.31 | (1.14–2.25) | 0.005 |
Hyperlipidemia (ref: No) | |||||
Yes | 1.65 | (1.01–2.24) | 0.93 | (0.61–1.51) | 0.798 |
Hypertension (ref: No) | |||||
Yes | 1.66 | (1.13–2.45) | 1.13 | (0.71–1.79) | 0.521 |
Diabetes (ref: No) | |||||
Yes | 1.90 | (1.35–2.66) | 1.43 | (0.97–2.11) | 0.061 |
Chronic kidney disease (ref: No) | |||||
Yes | 1.28 | (0.88–1.84) | 1.01 | (0.48–1.16) | 0.174 |
Alcohol use (ref: No) | |||||
Yes | 1.44 | (0.98–2.13) | 0.98 | (0.69–1.56) | 0.452 |
Drug abuse (ref: No) | |||||
Yes | 1.39 | (0.71–2.49) | 0.90 | (0.65–1.63) | 0.833 |
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Zhang, J.-Q.; Cheng, T.-M.; Lin, W.-C.; Chiu, K.-C.; Wu, S.-Y. Impact of Smoking-Related Chronic Obstruction Pulmonary Disease on Mortality of Invasive Ductal Carcinoma Patients Receiving Standard Treatments: Propensity Score-Matched, Nationwide, Population-Based Cohort Study. Cancers 2021, 13, 3654. https://doi.org/10.3390/cancers13153654
Zhang J-Q, Cheng T-M, Lin W-C, Chiu K-C, Wu S-Y. Impact of Smoking-Related Chronic Obstruction Pulmonary Disease on Mortality of Invasive Ductal Carcinoma Patients Receiving Standard Treatments: Propensity Score-Matched, Nationwide, Population-Based Cohort Study. Cancers. 2021; 13(15):3654. https://doi.org/10.3390/cancers13153654
Chicago/Turabian StyleZhang, Jia-Qiang, Tsai-Mu Cheng, Wei-Chun Lin, Kuo-Chin Chiu, and Szu-Yuan Wu. 2021. "Impact of Smoking-Related Chronic Obstruction Pulmonary Disease on Mortality of Invasive Ductal Carcinoma Patients Receiving Standard Treatments: Propensity Score-Matched, Nationwide, Population-Based Cohort Study" Cancers 13, no. 15: 3654. https://doi.org/10.3390/cancers13153654