Marina Baretti1, Lorenza Rimassa1, Nicola Personeni2, Laura Giordano1, Maria Chiara Tronconi1, Tiziana Pressiani1, Silvia Bozzarelli1, Armando Santoro3. 1. Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano, Milan, Italy. 2. Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano, Milan, Italy; Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy. Electronic address: nicola.personeni@hunimed.eu. 3. Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy.
Abstract
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.
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.
Authors: Rathin Gosavi; Clemente Chia; Michael Michael; Alexander G Heriot; Satish K Warrier; Joseph C Kong Journal: Int J Colorectal Dis Date: 2021-05-04 Impact factor: 2.571
Authors: Marcin Zeman; Marek Czarnecki; Ewa Chmielik; Adam Idasiak; Władysław Skałba; Mirosław Strączyński; Piotr J Paul; Agnieszka Czarniecka Journal: World J Surg Oncol Date: 2021-05-21 Impact factor: 2.754
Authors: Seyed M Qaderi; Boris Galjart; Cornelis Verhoef; Gerrit D Slooter; Miriam Koopman; Robert H A Verhoeven; Johannes H W de Wilt; Felice N van Erning Journal: Int J Colorectal Dis Date: 2021-04-04 Impact factor: 2.571