TY - JOUR
T1 - Effect of Comorbidities in Stage II/III Colorectal Cancer Patients Treated With Surgery and Neoadjuvant/Adjuvant Chemotherapy
T2 - A Single-Center, Observational Study
AU - Baretti, Marina
AU - Rimassa, Lorenza
AU - Personeni, Nicola
AU - Giordano, Laura
AU - Tronconi, Maria Chiara
AU - Pressiani, Tiziana
AU - Bozzarelli, Silvia
AU - Santoro, Armando
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Because of the aging of the population, cancer patients increasingly present with other medical comorbidities. In this retrospective study, we assessed the influence of comorbidities, using the Charlson Comorbidity Index (CCI), on the prognosis of patients with resected stage II/III colorectal cancer who underwent postoperative chemotherapy. We showed that higher CCI score is associated with poorer outcome and might predict long-term survival. Background: Comorbidity has a detrimental effect on cancer survival, however, it is difficult to disentangle its direct effect from its influence on treatment choice. In this study we assessed the effect of comorbidity on survival in patients who received standard treatment for resected stage II and III colorectal cancer (CRC). Patients and Methods: In total, 230 CRC patients, 68 rectal (29.6%) and 162 colon cancer (70.4%) treated with surgical resection and neoadjuvant/adjuvant chemotherapy from December 2002 to December 2009 at Humanitas Cancer Center were retrospectively reviewed. The key independent variable was the Charlson Comorbidity Index (CCI) score, measured as a continuous variable. The differences between groups for categorical data were tested using the χ2 test. Actuarial survival curves were generated using the Kaplan–Meier method. Results: Median follow-up was 113 (range, 8.2-145.0) months. Median age was 63 (range, 37-78) years. In univariate analysis CCI score was significantly associated with poorer disease-free survival (hazard ratio [HR], 1.65; 95% confidence interval [CI], 1.52-1.80; P <.001), and overall survival (OS; HR, 1.55; 95% CI, 1.41-1.71; P <.001). Factors associated with poorer outcome also included (stage III vs. stage II, P <.029) and age (age >70 vs. ≤70 years, P <.001). After adjusting for these factors, a significant negative prognostic role of CCI score was still observed (adjusted HR for OS, 1.59; 95% CI, 1.43-1.76; P <.001). Conclusion: Among CRC patients who underwent surgical resection and chemotherapy, a higher CCI score was associated with poorer outcome and might predict long-term survival.
AB - Because of the aging of the population, cancer patients increasingly present with other medical comorbidities. In this retrospective study, we assessed the influence of comorbidities, using the Charlson Comorbidity Index (CCI), on the prognosis of patients with resected stage II/III colorectal cancer who underwent postoperative chemotherapy. We showed that higher CCI score is associated with poorer outcome and might predict long-term survival. Background: Comorbidity has a detrimental effect on cancer survival, however, it is difficult to disentangle its direct effect from its influence on treatment choice. In this study we assessed the effect of comorbidity on survival in patients who received standard treatment for resected stage II and III colorectal cancer (CRC). Patients and Methods: In total, 230 CRC patients, 68 rectal (29.6%) and 162 colon cancer (70.4%) treated with surgical resection and neoadjuvant/adjuvant chemotherapy from December 2002 to December 2009 at Humanitas Cancer Center were retrospectively reviewed. The key independent variable was the Charlson Comorbidity Index (CCI) score, measured as a continuous variable. The differences between groups for categorical data were tested using the χ2 test. Actuarial survival curves were generated using the Kaplan–Meier method. Results: Median follow-up was 113 (range, 8.2-145.0) months. Median age was 63 (range, 37-78) years. In univariate analysis CCI score was significantly associated with poorer disease-free survival (hazard ratio [HR], 1.65; 95% confidence interval [CI], 1.52-1.80; P <.001), and overall survival (OS; HR, 1.55; 95% CI, 1.41-1.71; P <.001). Factors associated with poorer outcome also included (stage III vs. stage II, P <.029) and age (age >70 vs. ≤70 years, P <.001). After adjusting for these factors, a significant negative prognostic role of CCI score was still observed (adjusted HR for OS, 1.59; 95% CI, 1.43-1.76; P <.001). Conclusion: Among CRC patients who underwent surgical resection and chemotherapy, a higher CCI score was associated with poorer outcome and might predict long-term survival.
KW - Colon cancer
KW - Elderly
KW - Prognosis
KW - Recurrence
KW - Survival
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U2 - 10.1016/j.clcc.2018.03.010
DO - 10.1016/j.clcc.2018.03.010
M3 - Article
C2 - 29650416
AN - SCOPUS:85045044233
VL - 17
SP - e489-e498
JO - Clinical Colorectal Cancer
JF - Clinical Colorectal Cancer
SN - 1533-0028
IS - 3
ER -