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Psychiatric Comorbidities and Survival After Lobectomy for Stage I Non-Small Cell Lung Cancer
Journal article   Open access   Peer reviewed

Psychiatric Comorbidities and Survival After Lobectomy for Stage I Non-Small Cell Lung Cancer

Jesse York, James O’Toole, Andrea Makowski, Alyssa Woodward, Rebecca Suk, Roman Petrov, Charles Bakhos, Doraid Jarrar and Sai Yendamuri
Annals of thoracic surgery short reports, v 3(1), pp 138-143
01 Mar 2025
DOI: https://doi.org/10.1016/j.atssr.2024.07.013
PMID: 40098849
url
https://doi.org/10.1016/j.atssr.2024.07.013View
Published, Version of Record (VoR) Open

Abstract

The association between psychiatric comorbidities (PCs) and long-term survival after lobectomy for early-stage non-small cell lung cancer is unknown. We sought to investigate this relationship using the Surveillance, Epidemiology, & End-Results (SEER)-Medicare registry. Data for all patients in the SEER-Medicare registry who underwent lobectomy for stage I non-small cell lung cancer from 2007 to 2014 were included. Those older than 80 years at time of diagnosis, with multiple cancers, or histology other than adenocarcinoma or squamous cell carcinoma were excluded. Patients diagnosed with depression, anxiety, bipolar disorder, schizophrenia, other (non-schizophrenic) psychotic disorders, unspecified mood disorder, attention-deficit/hyperactivity disorder, alcohol use disorder, or substance use disorder prior to lung cancer diagnosis were considered to have a PC. Survival of patients with PC was compared to controls using univariable and multivariable analysis adjusting for age, sex, race, stage (IA/IB), histology, surgical approach, and Charlson Comorbidity Index. Of 5516 patients, 1369 (24.8%) had PCs. Patients with PCs were more likely to be younger (P < .001), female (P < .001), white (P < .001), and have stage IA cancer (P < .001). PC was associated with shorter survival (median, 2478 vs 2820 days; P = .002). Multivariable analysis retained PC in the final model, with a hazard ratio of 1.10 (P < .001). Subgroup analysis revealed that this survival difference was driven by differences in survival of patients with schizophrenia (P < .001) and alcohol use disorder (P = .006). Select psychiatric comorbidities are associated with reduced survival after lobectomy for early-stage non-small cell lung cancer. [Display omitted]

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