The impact of comorbidity on the overall survival and the cause of death in patients after colorectal cancer resection

Rieker, Ralf J.; Hammer, Eva Maria; Eisele, Roland; Schmid, E; Högel, Josef

doi:10.1007/s00423-002-0291-0

Cited by 53 publications

(31 citation statements)

References 30 publications

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“…Comorbidity has proven to be difficult to define and measure accurately [20,22]. However, as measured by the well-validated and extensively applied CCI, comorbidity has been shown to be an independent predictor of outcome (although with the association in the opposite direction to that in our study) in previous studies [25,29,34,35].…”

Section: Original Articlecontrasting

confidence: 53%

“…This was, therefore, a homogenous population in terms of overall health status that would make it more difficult to show an effect of comorbidity. In the analysis by Rieker et al [25], two-thirds of patients had CCI scores between 0 and 2 while one-third of patients had scores of >2. They showed that greater comorbidity was significantly correlated with shorter OS in patients who had undergone resection of colorectal cancer [25].…”

Section: Original Articlementioning

confidence: 99%

“…In the analysis by Rieker et al [25], two-thirds of patients had CCI scores between 0 and 2 while one-third of patients had scores of >2. They showed that greater comorbidity was significantly correlated with shorter OS in patients who had undergone resection of colorectal cancer [25]. Analysis of the prognostic value of age and comorbidity in the treatment of non-small-cell lung cancer by Asmis et al showed that greater comorbidity was associated with shorter OS in a heterogenous population of previously untreated patients (31% of whom had CCI scores of >1) receiving either adjuvant or palliative systemic therapy [29].…”

Section: Original Articlementioning

confidence: 99%

“…Among these, the most widely used is the Charlson Comorbidity Index (CCI) which, although developed in general medical patients, has been validated and found to have prognostic significance in patients with cancer including colorectal cancer [23][24][25]. The index includes 19 medical conditions weighted 1-6 based on the associated relative risk of death within 12 months; the sum of the weighted conditions is calculated to provide a total comorbidity score [23,24].…”

Section: Introductionmentioning

confidence: 99%

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Comorbidity, age and overall survival in cetuximab-treated patients with advanced colorectal cancer (ACRC)—results from NCIC CTG CO.17: a phase III trial of cetuximab versus best supportive care

et al. 2011

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Background:The interplay between comorbidity, age and performance status (PS) as predictors of outcome in advanced colorectal cancer (ACRC) is poorly understood. We examined these factors as predictors of treatment toxicity and outcome in cetuximab-treated patients with ACRC.Patients and methods: Comorbidity was independently evaluated using the Charlson Comorbidity Index (CCI), a validated measure of comorbidity based on the presence of medical conditions weighted according to their effect on mortality. CCI score was correlated with clinical and outcome data.Results: Five hundred and seventy-two patients were included; 41% were ‡65 years and 25% had comorbidities at randomization. In multivariate analysis (MVA) of all covariates, only older age was associated with greater comorbidity (P = 0.008). Overall survival (OS) was significantly better for patients with greater comorbidity in univariate analysis (P = 0.047). Conversely, better PS was associated with better OS in MVA (hazard ratio 1.92 for PS = 2 versus PS = 0, P < 0.0001). Age was not associated with OS (P = 0.13). Elderly patients had significantly less grade ‡3 vomiting (P = 0.034) but more dyspnea (P = 0.005). Patients with greater comorbidity had significantly less grade ‡3 vomiting (P = 0.002) but more non-neutropenic fever (P = 0.005). Conclusion:Better PS was associated with improved OS. For patients with good PS, restricting cetuximab use in the setting of significant comorbidity does not appear justified.

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Section: Original Articlecontrasting

confidence: 53%

Section: Original Articlementioning

confidence: 99%

Section: Original Articlementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comorbidity, age and overall survival in cetuximab-treated patients with advanced colorectal cancer (ACRC)—results from NCIC CTG CO.17: a phase III trial of cetuximab versus best supportive care

et al. 2011

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“…의 지표가 개발 및 적용되고 있으며,(7-9) 위암, (7,8) 유방암, (10)(11)(12)(13)(14)(15), 폐암, (11,16,17) 대장암, (6,11,18) 전립선암,(11) 방광암, (19) 및 신장암 (20) Table 3). CCI=Charlson Comorbidity Index; CI=confidence interval.…”

Section: 환자의 동반상병을 종합적으로 평가하기 위해 최근까지 여러 종류unclassified

Charlson Comorbidity Index as a Predictor of Long-Term Survival after Surgery for Breast Cancer: A Nationwide Retrospective Cohort Study in South Korea

et al. 2010

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Purpose:The aim of this article was to evaluate the impact of the Charlson Comorbidity Index (CCI) on long-term survival after surgery for breast cancer in South Korea. Methods: The study subjects were 29,562 women patients aged 20 years and older that underwent surgery for breast cancer between 2002 and 2005. The data were obtained from claims submitted to the National Health Insurance. All patients were censored at the follow-up cutoff date of June 30, 2006. Survival curves were estimated by the Kaplan-Meier method. Cox proportional hazards models were used to explore the impact of CCI on all-cause mortality. Results: After a followup time of 47 months, higher all-cause mortality was associated with an increasing CCI. In terms of the 4-year survival rate, among patients with CCI=1, it was 91.1%, among patients with CCI=2 it was 87.8%, and those patients with CCI≥3 it was 80.2%. Multivariate Cox proportional hazard analysis showed that CCI=1 (hazard ratios [HR], 1.10; 95% confidence interval [CI], 0.97-1.25), CCI=2 (HR, 1.61; 95% CI, 1.31-1.97) and CCI≥3 (HR, 2.27; 95% CI, 1.59-3.24), were associated with long-term survival. Conclusion: CCI is a strong predictor of long-term survival after surgery for breast cancer. We recommend the use of a validated comorbidity index in the selection of patients for breast surgery.

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The Impact of Comorbidity on Treatment (Chemoradiation and Laryngectomy) of Advanced, Nondistant Metastatic Laryngeal Cancer

Zhu¹,

Fedewa²,

Chen³

2012

Arch Otolaryngol Head Neck Surg

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This is the first study, to our knowledge, that demonstrates that patients with advanced laryngeal cancer with 1 or more comorbidities are more likely to receive surgery than chemoradiation compared with patients without any comorbidity, independent of numerous clinical and nonclinical variables among a large national cohort. A limitation of this study is the use of comorbidity data from the National Cancer Database, which gathers its information from hospital discharge face sheets. We recognize that the National Cancer Database may be an imperfect system for the collection of comorbidity data and encourage discussion on different methods to improve the system, including incorporating comorbidity data from the Surveillance, Epidemiology, and End Results Medicare Database and medical chart-based comorbidity data collection by cancer registrars.

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The impact of comorbidity on the overall survival and the cause of death in patients after colorectal cancer resection

Abstract: Standardized comorbidity should be considered as a factor in survival studies of CRC.

Cited by 53 publications

References 30 publications

Comorbidity, age and overall survival in cetuximab-treated patients with advanced colorectal cancer (ACRC)—results from NCIC CTG CO.17: a phase III trial of cetuximab versus best supportive care

Comorbidity, age and overall survival in cetuximab-treated patients with advanced colorectal cancer (ACRC)—results from NCIC CTG CO.17: a phase III trial of cetuximab versus best supportive care

Charlson Comorbidity Index as a Predictor of Long-Term Survival after Surgery for Breast Cancer: A Nationwide Retrospective Cohort Study in South Korea

The Impact of Comorbidity on Treatment (Chemoradiation and Laryngectomy) of Advanced, Nondistant Metastatic Laryngeal Cancer

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