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. 2021 Jun 1:13:4373-4381.
doi: 10.2147/CMAR.S304980. eCollection 2021.

Survival of Patients with Lung Cancer in the Setting of Liver Cirrhosis: A Multicenter Propensity Score Matching Study

Ming-Shian Lu  1 , Hung-I Lu  2 , Tzu-Ping Chen  3 , Che-Chia Chang  1 , Tsung-Ming Yang  4 , Miao-Fen Chen  5   6
Affiliations

Survival of Patients with Lung Cancer in the Setting of Liver Cirrhosis: A Multicenter Propensity Score Matching Study

Ming-Shian Lu et al. Cancer Manag Res. .

Abstract

Purpose: The survival outcome of lung cancer patients with coexisting liver cirrhosis has thus far received limited attention in the literature. In this study, we evaluated whether liver cirrhosis is an independent risk factor for the survival of patients with lung cancer.

Materials and methods: We conducted a retrospective, multicenter, propensity-matched study of lung cancer patients with and without liver cirrhosis. To determine differences in survival, we sought to identify risk factors associated with poor outcomes using Kaplan-Meier survival analysis and Cox proportional hazards regression.

Results: There were no statistically significant differences in the baseline clinical characteristics of patients between the cirrhosis and non-cirrhosis groups. The median overall survival of patients with and without cirrhosis was 13.07 months (95% confidence interval [CI]: 10.56-16.84) and 13.67 months (95% CI: 10.42-16.91), respectively (p=0.76). Cox proportional hazards regression analysis revealed that liver cirrhosis was not an independent risk factor for poor outcome (hazard ratio [HR]: 1.057, 95% CI: 0.805-1.388, p=0.690). In patients with cirrhosis, lower serum albumin levels, higher Charlson Comorbidity Index score, advanced-stage lung cancer, and treatment modality were factors associated with poor outcome. Increase in serum albumin by 1 g was associated with a 30% reduction in the risk of mortality (HR: 0.700, 95% CI: 0.494-0.993, p=0.045). While every point increase in the Charlson Comorbidity Index score by 1 point was linked to a 9% higher risk of mortality (HR: 1.090, 95% CI: 1.023-1.161, p=0.007).

Conclusion: The survival rates of lung cancer patients with and without cirrhosis did not differ significantly. Higher serum albumin levels and lower Charlson Comorbidity Index scores were associated with improved survival.

Keywords: liver cirrhosis; lung neoplasm; outcome; survival.

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Conflict of interest statement

The authors have no conflicts of interest to report in this work.

Figures

Figure 1
Figure 1
Patient selection and matching process.
Figure 2
Figure 2
Survival curve for lung cancer patients with and without cirrhosis. There was no statistically significant difference in survival for WITH-Cirrhosis and WITHOUT-Cirrhosis lung cancer patients. The median overall survival for patients WITH-Cirrhosis was 13.07 months (95% CI 10.56–16.84) compared to 13.67 months (95% CI 10.42–16.91) for patients WITHOUT-Cirrhosis, p=0.76.
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