Trautmann F, Singer S, Schmitt J
Center for Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany.
National Center for Tumor Diseases (NCT) (partner site) Dresden and German Cancer Research Center (DKFZ), Dresden, Germany.
Eur J Cancer Care (Engl). 2017 Nov;26(6). doi: 10.1111/ecc.12605. Epub 2016 Dec 13.
Soft tissue sarcoma comprises a heterogeneous group of solid malignant tumours. Comorbidities are important prognostic factors for survival and adversely impact quality of life. We examined the complex relationship between soft tissue sarcoma and comorbidities over time in a large population-based sample. The study uses routine data from the German statutory healthcare system (n = 2,615,865). Case identification of soft tissue sarcoma and comorbid diseases was based on ICD-10 codes and diagnostic modifiers. Uni- and multivariate regression models were used to obtain risk estimates for chronic somatic and mental comorbidities in soft tissue sarcoma patients compared to a cancer-free control group. At diagnosis, patients with soft tissue sarcoma were significantly more likely to be affected with prevalent bronchial asthma, ≥1 cardiovascular risk factor (hypertension, angina pectoris, heart failure, peripheral arterial disease and thrombosis), back pain, depression, anxiety disorder and adjustment disorder than cancer-free controls. During the course of disease, sarcoma patients were at a significantly higher risk to develop incident depression, anxiety disorder and adjustment disorder. Comorbidities need to be considered in clinical decision making regarding the treatment of soft tissue sarcoma patients. Psycho-oncological treatment should be incorporated into medical care of patients with sarcoma.
软组织肉瘤是一组异质性的实体恶性肿瘤。合并症是影响生存的重要预后因素,对生活质量有不利影响。我们在一个基于人群的大样本中,研究了软组织肉瘤与合并症之间随时间变化的复杂关系。该研究使用了德国法定医疗保健系统的常规数据(n = 2,615,865)。软组织肉瘤和合并疾病的病例识别基于国际疾病分类第10版(ICD - 10)编码和诊断修饰词。使用单变量和多变量回归模型,以获得软组织肉瘤患者与无癌对照组相比,慢性躯体和精神合并症的风险估计值。在诊断时,与无癌对照组相比,软组织肉瘤患者患支气管哮喘、≥1种心血管危险因素(高血压、心绞痛、心力衰竭、外周动脉疾病和血栓形成)、背痛、抑郁症、焦虑症和适应障碍的可能性显著更高。在疾病过程中,肉瘤患者发生新发抑郁症、焦虑症和适应障碍的风险显著更高。在软组织肉瘤患者的临床决策中需要考虑合并症。心理肿瘤学治疗应纳入肉瘤患者的医疗护理中。