AUTHOR=Li Ningning , Gao Liwei , Bai Chunmei , Zhao Lin , Shao Yajuan 

TITLE=Clinical features and prognosis of lung cancer in patients with connective tissue diseases: a retrospective cohort study

JOURNAL=Frontiers in Oncology

VOLUME=Volume 13 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1167213

DOI=10.3389/fonc.2023.1167213

ISSN=2234-943X

ABSTRACT=Background: Studies have demonstrated a close association between connective tissue diseases (CTDs) and lung cancer (LC). Evidence supports that poor survival may be associated with the presence of CTDs in patients with LC. 
Methods: This retrospective cohort study investigated 29 LC patients with CTDs, and 116 LC patients without CTDs were enrolled as case-matched control cohorts. Medical records, therapeutic efficacy of cancer, and outcomes were analyzed. 
Results: The median duration from the diagnosis of CTDs to LC was 17 years. The Eastern Cooperative Oncology Group (ECOG) performance score for LC-CTD patients was worse than that for matched non-CTD LC patients. The median progression-free survival (mPFS) and overall survival (mOS) of first-line chemotherapy did not differ between lung adenocarcinoma (AC) patients with and without CTDs. A significant difference was observed in mPFS (4 months vs. 17 months, hazard ratio [HR] 9.987, p=0.004) and mOS (6 months vs. 35 months, HR 26.009, p<0.001) of first-line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) treatment between AC patients with and without CTDs. The presence of CTD, sex, ECOG performance status, and tumor-node-metastasis clinical stage were independent prognostic factors in all patients with non-small cell LC (NSCLC). ECOG performance status was determined to be an independent prognostic factor in the LC-CTD patients. In NSCLC patients with CTD (n=26), sex (male) and worse ECOG score were independent poor prognostic factors.
Conclusions: CTDs were associated with poor survival in patients with LC. The therapeutic efficacy of first-line EGFR-TKI therapy was significantly worse in lung AC patients with CTDs than in those without CTDs. ECOG performance status was determined as an independent prognostic factor for patients with LC and CTDs.