Background/Objectives: Patients with gastric cancer (GC) have an elevated risk of atrial fibrillation (AF) and cardiovascular mortality, compared with the general population. However, the effect of the cancer stage on the development of AF remains unclear. This study aimed to evaluate the relationship between the risk of AF and GC stage based on the Surveillance, Epidemiology, and End Results (SEER) stage classifications. Methods: This retrospective population-based cohort study enrolled patients diagnosed with GC between 2012 and 2019, using anonymized data from the Cancer Public Library Database of South Korea. Patients were followed up until 2020. The risk of AF was assessed in relation to the SEER stage of GC (localized, regional, distant) using adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs). Subgroup analyses were performed according to age, sex, year of diagnosis, and comorbidities. Results: Of the 211,500 patients enrolled in this study, 7266 were diagnosed with AF during follow-up. The risk of AF increased progressively with cancer stage, with aHRs of 2.00 (95% CI 1.81–2.22) for the distant stage and 1.32 (95% 1.25–1.41) for the regional stage, compared with the localized stage. Subgroup analyses showed a consistent association between advanced cancer stage and a higher AF risk; the association was stronger in the younger, female, and non-hypertensive subgroups. Conclusions: The risk of AF in patients with GC is associated with the initial stage, highlighting the need for the closer monitoring and management of AF to improve the survival of patients with advanced-stage GC.
背景/目的：与普通人群相比，胃癌患者发生心房颤动和心血管死亡的风险更高。然而，癌症分期对房颤发生的影响尚不明确。本研究旨在基于监测、流行病学和最终结果分期系统，评估胃癌分期与房颤风险之间的关系。方法：这项基于人群的回顾性队列研究利用韩国癌症公共图书馆数据库的匿名化数据，纳入了2012年至2019年间确诊的胃癌患者，随访至2020年。通过校正风险比及其95%置信区间，评估不同SEER分期（局限期、区域期、远处转移期）胃癌患者的房颤风险，并依据年龄、性别、确诊年份及合并症进行亚组分析。结果：在纳入研究的211,500例患者中，7,266例在随访期间确诊房颤。与局限期胃癌相比，区域期和远处转移期患者的房颤风险呈渐进性升高，校正风险比分别为1.32（95% CI 1.25-1.41）和2.00（95% CI 1.81-2.22）。亚组分析显示晚期胃癌与较高房颤风险存在稳定关联，且在年轻、女性及非高血压亚组中该关联更为显著。结论：胃癌患者的房颤风险与初始分期相关，这提示需要对晚期胃癌患者加强房颤监测与管理，以改善其生存预后。
肿瘤(癌症)患者之家