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Review
. 2023 Feb;12(3):2179-2186.
doi: 10.1002/cam4.5104. Epub 2022 Aug 3.

Competing risk analysis of cardiovascular death in patients with primary gallbladder cancer

Chong Chen  1   2 , Fengshuo Xu  1   3 , Shiqi Yuan  2   4 , Xuenuo Zhao  2   5 , Mengmeng Qiao  1   2 , Didi Han  1   3 , Jun Lyu  1   6
Affiliations
Review

Competing risk analysis of cardiovascular death in patients with primary gallbladder cancer

Chong Chen et al. Cancer Med. 2023 Feb.

Abstract

Background: Developments in medical technology are resulting in continuous decreases in the cancer mortality rate of patients with gallbladder cancer, while non-cancer deaths in cancer patients are becoming more common. The main cause of this is cardiovascular mortality (CVM). The purpose of this study was to determine the CVM risk in patients with primary gallbladder cancer (PGC).

Methods: We extracted information on patients in the SEER database who were diagnosed with PGC from 2004 to 2015, compared CVM in patients with PGC with the general United States population, and calculated standardized mortality rates (SMRs) and the absolute excess risk. A competing risks model was used to identify and analyze the independent risk factors for cardiovascular death in patients with PGC.

Results: This study included 5925 patients, 247 of whom died from cardiovascular disease. The SMR of cardiovascular death in patients with PGC was 15.84 (95% confidence interval: 15.83-15.85), and the SMR was slightly lower in male than female patients. The competing risks analysis indicated that age, marital status, cancer cell differentiation, chemotherapy status, and year of diagnosis were risk factors for cardiovascular death in patients with PGC.

Conclusions: The CVM risk is considerably higher in patients with PGC than in the general population. It is therefore very necessary to apply cardioprotective interventions to patients with PGC.

Keywords: cancer education; cancer risk factors; cholangiocarcinoma; clinical cancer research; epidemiology.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Patient extraction flowchart.
FIGURE 2
FIGURE 2
CIF of all causes of death in PGC patients. (A) age, (B) sex, (C) race, (D) marry, (E) surgical, (F) radiotherapy, (G) chemotherapy, (H) distant metastasis, (I) grade, (J) lymph node metastasis, (K) year of diagnosis. CIF, cumulative incidence function; CVD, cardiovascular death; OCDs, other cancer deaths; ONCDs, other non‐cancer deaths; PCD, primary gallbladder cancer death.
FIGURE 3
FIGURE 3
CIF of all subgroups of gallbladder cancer patients dying from all causes. CIF, cumulative incidence function.
FIGURE 4
FIGURE 4
Multifactor competitive risk forest plot.
See this image and copyright information in PMC

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