Risk and Prognosis factors for Systemic Sclerosis with Lung Cancer: A Single-Center Case-control Study in China

Lung Cancer

Int J Clin Pract. 2020 Nov 6:e13819. doi: 10.1111/ijcp.13819. Online ahead of print.


OBJECTIVE: To analyze clinical characteristics, risk and prognosis factors for systemic sclerosis (SSc) patients with lung cancer.

METHODS: SSc patients with lung cancer admitted to Peking Union Medical College Hospital from February 1992 to December 2018 were included. Age and sex-matched controls were selected from a pool of SSc patients without lung cancer during the same period. Conditional logistic regression and Cox proportional-hazard regression were used to identify risk factors and prognosis factors. The Kaplan-Meier method was used to draw the survival curve and calculate median survival.

RESULTS: Nineteen SSc patients with lung cancer and 76 controls were included. The mean age at lung cancer diagnosis was 54.4 ± 10.2 years. In all 19 cases the lung cancer had been diagnosed after SSc and the median interval between SSc onset and lung cancer onset was 10.5 years (range 2.0-36.2 years). Among SSc patients with lung cancer, the median follow-up time and median survival were 2.6 years and 1.4 years, respectively. In the sex and age-matched conditional logistic multivariable regression analysis, family history of malignancy(OR 4.930, 95%CI 1.926-12.619, p 0.001), ILD(OR 7.701, 95%CI 1.009-58.767, p 0.049) were independent risk factors for lung cancer among SSc patients, and considering sex and age of SSc onset, SSc patients with more advanced staging of lung cancer(HR 3.190, 95%CI 1.127-6.126, p 0.06) had poorer prognosis.

CONCLUSION: Lung cancer is not uncommon in SSc patients, especially those with family histories of malignancy or ILD. Early detection of lung cancer is of vital importance for better prognosis.