PURPOSE: The impact of comorbidity on the outcome of colorectal cancer is poorly understood. We examined the prevalence of comorbidity and its impact on survival among Danish colorectal cancer patients. METHODS: The hospital discharge registries in northern Denmark were used to identify 13,190 patients diagnosed with colorectal cancer between 1995 and 2006, and to assess their comorbidity using the Charlson Comorbidity Index. We obtained product limit estimates of 1-year and 5-year crude survival based on three levels of comorbidity. To quantify the impact of comorbidity on mortality, we used Cox's proportional hazards regression analysis to compute the mortality rate ratio. RESULTS: One-third of the patients had recorded comorbid conditions. Patients with moderate and severe comorbidity (Charlson scores 1-2 and score 3+) had considerably higher 1-year and 5-year mortality rates compared to patients without comorbidity. For colon cancer patients, 1-year estimates in 2004 to 2006 were mortality rate ratio1-2 = 1.2 (95 percent confidence interval, 1.0-1.5) and mortality rate ratio3+ = 1.8 (95 percent confidence interval, 1.4-2.3). For rectal cancer patients with severe comorbidity, the negative impact on survival increased over time. CONCLUSIONS: Comorbidity was a strong negative prognostic factor for survival among colorectal cancer patients.
PURPOSE: The impact of comorbidity on the outcome of colorectal cancer is poorly understood. We examined the prevalence of comorbidity and its impact on survival among Danish colorectal cancerpatients. METHODS: The hospital discharge registries in northern Denmark were used to identify 13,190 patients diagnosed with colorectal cancer between 1995 and 2006, and to assess their comorbidity using the Charlson Comorbidity Index. We obtained product limit estimates of 1-year and 5-year crude survival based on three levels of comorbidity. To quantify the impact of comorbidity on mortality, we used Cox's proportional hazards regression analysis to compute the mortality rate ratio. RESULTS: One-third of the patients had recorded comorbid conditions. Patients with moderate and severe comorbidity (Charlson scores 1-2 and score 3+) had considerably higher 1-year and 5-year mortality rates compared to patients without comorbidity. For colon cancerpatients, 1-year estimates in 2004 to 2006 were mortality rate ratio1-2 = 1.2 (95 percent confidence interval, 1.0-1.5) and mortality rate ratio3+ = 1.8 (95 percent confidence interval, 1.4-2.3). For rectal cancerpatients with severe comorbidity, the negative impact on survival increased over time. CONCLUSIONS: Comorbidity was a strong negative prognostic factor for survival among colorectal cancerpatients.
Authors: Stefano Marventano; Giuseppe Grosso; Antonio Mistretta; Marta Bogusz-Czerniewicz; Roberta Ferranti; Francesca Nolfo; Gabriele Giorgianni; Stefania Rametta; Filippo Drago; Francesco Basile; Antonio Biondi Journal: Int J Colorectal Dis Date: 2014-07-27 Impact factor: 2.571
Authors: Charbel Sandroussi; Chantelle Brace; Erin D Kennedy; Nancy N Baxter; Steven Gallinger; Alice C Wei Journal: J Gastrointest Surg Date: 2010-06-23 Impact factor: 3.452
Authors: Sophie Cai; Theodore S Hong; Saveli I Goldberg; Carlos Fernandez-del Castillo; Sarah P Thayer; Cristina R Ferrone; David P Ryan; Lawrence S Blaszkowsky; Eunice L Kwak; Christopher G Willett; Keith D Lillemoe; Andrew L Warshaw; Jennifer Y Wo Journal: Cancer Date: 2013-09-04 Impact factor: 6.860
Authors: Simon Yang; Shabbir M H Alibhai; Erin D Kennedy; Abraham El-Sedfy; Matthew Dixon; Natalie Coburn; Alex Kiss; Calvin H L Law Journal: HPB (Oxford) Date: 2014-06-24 Impact factor: 3.647
Authors: Charlotte E Joslin; Katherine C Brewer; Faith G Davis; Kent Hoskins; Caryn E Peterson; Heather A Pauls Journal: Gynecol Oncol Date: 2014-08-28 Impact factor: 5.482