Age-Adjusted Charlson Comorbidity Index Scores as Predictor of Survival in Colorectal Cancer Patients Who Underwent Surgical Resection and Chemoradiation

Wu, Chin-Chia; Hsu, Ta-Wen; Chang, Chin-Chun; Yu, Chia-Hui; Lee, Ching‐Chih

doi:10.1097/md.0000000000000431

Cited by 73 publications

(62 citation statements)

References 35 publications

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“…Univariate analysis revealed that both the OS and DFS of these samples were associated with age (P = 0.005; P = 0.006, respectively), tumor size (P = 0.028; P = 0.031, respectively), tumor location (P = 0.017; P = 0.020, respectively), pT stage (P = 0.004; P = 0.005, respectively), pN stage (P < 0.001), distant metastasis (P < 0.001), AJCC stage (P < 0.001), differentiation (P = 0.014; P = 0.015, respectively). Moreover, the multivariate analysis showed that only age (P = 0.004) and AJCC stage (P < 0.001) remained significantly independent prognostic factors, which was in accordance with other studies of large cohorts of CRC patients2324.…”

Section: Resultssupporting

confidence: 90%

A comparative analysis and guidance for individualized chemotherapy of stage II and III colorectal cancer patients based on pathological markers

Han

et al. 2016

Sci Rep

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Adjuvant chemotherapy is considered the standard of care for patients with colorectal cancer after curative resection. Although current guidelines provide clear instructions for chemotherapy for stage II high-risk and stage III colorectal cancer, it is insufficient to individualize therapy. We analyzed the outcomes of 902 patients with colorectal cancer treated with or without chemotherapy in our hospital. We found Chinese survival benefit for chemotherapy was consistent with current guidelines. Moreover, our data added to the evidence that chemotherapy might be used for elderly patients with stage II high-risk colorectal cancer. Pathological markers could predict response to individualize therapy in a convenient, fast and inexpensive way. We compared survivals of patients with stage II high-risk and stage III colorectal cancer with chemotherapy in different pathological markers expression, and furthermore used 458 colon adenocarcinoma samples from The Cancer Genome Atlas to verify our preliminary results. We confirmed TOPIIα, EGFR and P170 may be sufficiently predictive markers to individualize chemotherapy. FOLFOX was the optimal adjuvant chemotherapy for patients with stage II high-risk and stage III colorectal cancer when TOPIIα was positive or EGFR or P170 was negative.

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Section: Resultssupporting

confidence: 90%

A comparative analysis and guidance for individualized chemotherapy of stage II and III colorectal cancer patients based on pathological markers

Han

et al. 2016

Sci Rep

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“…Muscle abnormalities, including low skeletal mass index (SMI, quantified as muscle cross‐sectional area adjusted by height squared, cm 2 /m 2 ) and low skeletal muscle radiodensity (SMD, quantified in Hounsfield units, HU), can be measured using computerized tomography (CT) images. Both these muscle abnormalities have been associated with the presence of specific co‐morbid conditions as well as cancer prognosis, and thus are potential mechanisms explaining why certain co‐morbid conditions are associated with worse cancer prognosis . Low SMI, also termed sarcopenia, is highly prevalent and has been shown as a strong prognostic factor in CRC patients and in many other types of cancer .…”

Section: Introductionmentioning

confidence: 99%

Associations of pre‐existing co‐morbidities with skeletal muscle mass and radiodensity in patients with non‐metastatic colorectal cancer

Xiao

Caan

Weltzien

et al. 2018

J cachexia sarcopenia muscle

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Background and aimCo‐morbidities and computerized tomography‐measured muscle abnormalities are both common in cancer patients and independently adversely influence clinical outcomes. Muscle abnormalities are also evident in other diseases, such as diabetes and obesity. This study examined for the first time the association between co‐morbidities and muscle abnormalities in patients diagnosed with colorectal cancer (CRC).MethodsThis cross‐sectional study included 3051 non‐metastatic patients with Stages I–III CRC. Muscle abnormalities, measured at diagnosis, were defined as low skeletal muscle mass index (SMI) or low skeletal muscle radiodensity (SMD) quantified using computerized tomography images using optimal stratification. Co‐morbidities included in the Charlson index were ascertained. χ2 tests were used to compare the prevalence of co‐morbidities by the presence or absence of each muscle abnormality. Logistic regressions were performed to evaluate which co‐morbidities predicted muscle abnormalities adjusting for age, sex, body mass index, weight change, cancer stage, cancer site, race/ethnicity, and smoking.ResultsMean age was 63 years; 50% of patients were male. The prevalence of low SMI and low SMD were 43.1% and 30.2%, respectively. Co‐morbidities examined were more prevalent in patients with low SMD than in those with normal SMD, and most remained independent predictors of low SMD after adjustment for covariates. Co‐morbidities associated with higher odds of low SMD included myocardial infarction [odds ratio (OR) = 1.77, P = 0.023], congestive heart failure (OR = 3.27, P < 0.001), peripheral vascular disease (OR = 2.15, P = 0.002), diabetes with or without complications (OR = 1.61, P = 0.008; OR = 1.46, P = 0.003, respectively), and renal disease (OR = 2.21, P < 0.001). By contrast, only diabetes with complications was associated with lower odds of low SMI (OR = 0.64, P = 0.007).ConclusionsPrevalence of muscle abnormalities was high in patients with non‐metastatic CRC. Pre‐existing co‐morbidities were associated with low SMD, suggestive of a potential shared mechanism between fat infiltration into muscle and each of these co‐morbidities.

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“…The Age-Adjusted Charlson Index to is a valid and reliable instrument; 118 however, it does not represent functional impairment, which could influence cancer screening, particularly in older adults. 119-121 Future studies should also include functional impairment.…”

Section: Discussionmentioning

confidence: 99%

Impact of Age and Comorbidity on Cervical and Breast Cancer Literacy of African Americans, Latina, and Arab Women

Talley

Williams

2015

Nursing Clinics of North America

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Background Appropriate and timely screening can significantly reduce breast and cervical cancer morbidity and mortality. Racial/ethnic minorities and immigrant populations have lower screening rates and delays in follow-up after abnormal tests. Purpose In this study, we examined the relationship between age, comorbidity, breast and cervical cancer literacy in a sample of African American, Latina, and Arab women (N=371) from Detroit, Michigan. Methods Age-adjusted Charlson Comorbidity Index (ACC) was used characterize the impact of age and comorbidity has on breast and cervical cancer literacy; Breast Cancer Literacy Assessment Tool was used to assess breast cancer literacy; Cervical Cancer Literacy Assessment Tool was used to assess cervical cancer literacy. ANOVA was used to assess the relationship between ACC, breast and cervical cancer screening and group differences. Results There was a statistically significant difference between breast cancer literacy (Breast-CLAT total scores) scores (F(2,367)= 17.31, p= < 0.01). ACC had a greater impact on breast cancer literacy for African American F(2,214) =11, p = <0.01.

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Age-Adjusted Charlson Comorbidity Index Scores as Predictor of Survival in Colorectal Cancer Patients Who Underwent Surgical Resection and Chemoradiation

Cited by 73 publications

References 35 publications

A comparative analysis and guidance for individualized chemotherapy of stage II and III colorectal cancer patients based on pathological markers

A comparative analysis and guidance for individualized chemotherapy of stage II and III colorectal cancer patients based on pathological markers

Associations of pre‐existing co‐morbidities with skeletal muscle mass and radiodensity in patients with non‐metastatic colorectal cancer

Impact of Age and Comorbidity on Cervical and Breast Cancer Literacy of African Americans, Latina, and Arab Women

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