AIM: To quantify the effect of comorbidity on stage-specific survival in resected non-small cell lung cancer (NSCLC) patients. METHODS: From the Danish Lung Cancer Registry, 20,461 patients diagnosed with lung cancer between 1st January 2005 and 31st December 2010 were identified. Among 3152 NSCLC patients who underwent surgical resection, mortality hazard ratios were calculated during three consecutive time periods following surgery (0-1 month, 1 month-1 year and >1 year) according to Charlson comorbidity score (CCS 0, 1, 2, 3+), Eastern Cooperative Oncology Group (ECOG) performance status, lung function, age, sex, pathological T (pT) and N (pN) stage using Cox proportional hazard modelling. The Kaplan Meier method was used to describe stage-specific survival according to the CCS. RESULTS: Severe comorbidity (CCS 3+) was independently associated with significantly higher death rates throughout the three periods of follow-up [Hazard ratio (HR) 2.06 (1.13-3.75) for CCS 3+ in 0-1 month, 1.57 (1.17-2.12) 3+ during1 month-1 year and 1.84 (1.42-2.37) after 1 year]. Stage-specific 5-year survival in patients with severe comorbidity was significantly lower than in patients without comorbid disease [e.g. 38% (95% confidence interval (CI) 23-53%) for pT1 and CCS 3+ versus 69% (62-75%) for pT1 and CCS 0]. CONCLUSION: Severe comorbidity affects survival of NSCLC patients who undergo surgical resection by as much as a single stage increment and this effect persists throughout follow-up. Further research may be necessary to help identify which patients are most likely to benefit from surgery.
AIM: To quantify the effect of comorbidity on stage-specific survival in resected non-small cell lung cancer (NSCLC) patients. METHODS: From the Danish Lung Cancer Registry, 20,461 patients diagnosed with lung cancer between 1st January 2005 and 31st December 2010 were identified. Among 3152 NSCLCpatients who underwent surgical resection, mortality hazard ratios were calculated during three consecutive time periods following surgery (0-1 month, 1 month-1 year and >1 year) according to Charlson comorbidity score (CCS 0, 1, 2, 3+), Eastern Cooperative Oncology Group (ECOG) performance status, lung function, age, sex, pathological T (pT) and N (pN) stage using Cox proportional hazard modelling. The Kaplan Meier method was used to describe stage-specific survival according to the CCS. RESULTS: Severe comorbidity (CCS 3+) was independently associated with significantly higher death rates throughout the three periods of follow-up [Hazard ratio (HR) 2.06 (1.13-3.75) for CCS 3+ in 0-1 month, 1.57 (1.17-2.12) 3+ during1 month-1 year and 1.84 (1.42-2.37) after 1 year]. Stage-specific 5-year survival in patients with severe comorbidity was significantly lower than in patients without comorbid disease [e.g. 38% (95% confidence interval (CI) 23-53%) for pT1 and CCS 3+ versus 69% (62-75%) for pT1 and CCS 0]. CONCLUSION: Severe comorbidity affects survival of NSCLCpatients who undergo surgical resection by as much as a single stage increment and this effect persists throughout follow-up. Further research may be necessary to help identify which patients are most likely to benefit from surgery.
Authors: Takashi Eguchi; Sarina Bains; Ming-Ching Lee; Kay See Tan; Boris Hristov; Daniel H Buitrago; Manjit S Bains; Robert J Downey; James Huang; James M Isbell; Bernard J Park; Valerie W Rusch; David R Jones; Prasad S Adusumilli Journal: J Clin Oncol Date: 2016-10-31 Impact factor: 44.544
Authors: Maria Iachina; Erik Jakobsen; Henrik Møller; Margreet Lüchtenborg; Anders Mellemgaard; Mark Krasnik; Anders Green Journal: Lung Date: 2014-12-17 Impact factor: 2.584
Authors: F J Gonzalez-Barcala; J A Falagan; J M Garcia-Prim; L Valdes; J M Carreira; A Puga; P Martín-Lancharro; M T Garcia-Sanz; D Anton-Sanmartin; J C Canive-Gomez; A Pose-Reino; R Lopez-Lopez Journal: Ir J Med Sci Date: 2013-10-04 Impact factor: 1.568
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
Authors: S Andrew Skillington; Dorina Kallogjeri; James S Lewis; Jay F Piccirillo Journal: JAMA Otolaryngol Head Neck Surg Date: 2016-06-01 Impact factor: 6.223
Authors: Lise Vilstrup Holm; Dorte Gilså Hansen; Jakob Kragstrup; Christoffer Johansen; Rene dePont Christensen; Peter Vedsted; Jens Søndergaard Journal: Support Care Cancer Date: 2014-03-19 Impact factor: 3.603