Association between Charlson comorbidity index score and outcome in patients with stage IIIB-IV non-small cell lung cancer

Abstract

BackgroundThis retrospective study investigated the association between the Charlson comorbidity index (CCI) score and the survival of patients with stage IIIB-IV (advanced, non-resectable) non-small cell lung cancer (NSCLC) who also did not have gene mutations in epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK).MethodsThe records of 165 patients (28–80 y, median 61 y) who met the above criteria and were admitted to Beijing Friendship Hospital Capital Medical University from 1 May 2010 to 1 October 2014were reviewed. Associations between baseline variables and the CCI score were assessed via univariate and multivariate logistic regression analysis. Overall survival was defined as the time from the first clinic visit to death from any cause, or to the end of follow-up. Survival curves were estimated via the Kaplan-Meier method and compared with the log-rank test.ResultsLogistic regression analyses indicated that smoking and performance status were independently associated with the CCI score. Smoking was associated with an increased risk of mortality (odds ratio (OR) 4.12 (95% confidence interval [CI] 1.92–8.84) compared to non-smokers), as was performance status 2 (ambulatory, capable of self-care, unable to perform any work activities; active for >50% of waking hours) (OR 2.22 (95% CI, 1.14–4.33) compared to performance status 1). Univariate Cox’s regression analyses showed that the hazard ratios were significantly associated with the CCI score (P = 0.009), smoking (P = 0.042), and male gender (P = 0.021).ConclusionThe CCI score is an important prognostic factor for the prediction of overall survival in patients with stage IIIB-IV NSCLC who are negative for EGFR and ALK gene mutations.

Clinical characteristics and survival in non-small cell lung cancer patients by smoking history: a population-based cohort study

“…According to current recommendations, patients with pleural effusions should be treated with chemotherapy, similar to stage IV patients. The finding of a lower comorbidity burden in never-smokers was expected and confirmed results from previous studies [47,48].…”

Economic Burden of Checkpoint Inhibitor Immunotherapy for the Treatment of Non–Small Cell Lung Cancer in US Clinical Practice

“…To minimize the known potential for patient misclassification, we used a validated case-finding algorithm to identify NSCLC cases 36 and included only patients with a diagnosis of metastasis based on ICD diagnosis codes. The Charlson comorbidity index scores in both the unmatched (6.4e6.9) and PS-matched (6.9e7.0) cohorts were in the expected range for this population, 50 and were much higher than those reported in the aforementioned study (2.2e3.0), 35 providing additional confirmation of accurate ascertainment of patients with advanced NSCLC. We used CPI drug label indications to restrict the inclusion of patients in the non-CPI cohort to those who were eligible for CPI but received other agents; however, the impact of other patient characteristics, such as comorbidities, could not be accounted for.…”

Comparing comorbidity scales: Attending physician score versus the Cumulative Illness Rating Scale for Geriatrics

“…The results from studies of advanced NSCLC patients receiving chemotherapy are somewhat mixed. Some find comorbidity to be a prognostic factor [264], while others do not, i.e., consistent with our findings [35,265]. The results of all the studies mentioned above are, however, not directly comparable to ours since they either differed in the comorbidity scale used, stages of disease included, or types of treatment given.…”