Parés-Badell Oleguer, Banqué Marta, Macià Francesc, Castells Xavier, Sala Maria
Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona 08003, Spain; Public Health Agency of Barcelona, 1 Pl. de Lesseps, Barcelona, 08023, Spain.
Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona 08003, Spain; European Higher Education Area (EHEA) Degree Programme in Preventive Medicine and Public Health, Fundació Universitària del Bages (FUB), Manresa 08243, Barcelona, Spain; Research network on health services in chronic diseases (REDISSEC), Madrid 28029, Spain.
Cancer Epidemiol. 2017 Aug;49:66-74. doi: 10.1016/j.canep.2017.05.010. Epub 2017 Jun 3.
To assess the impact of comorbidity, measured by the Charlson Comorbidity Index (CCI), on survival in breast, colorectal and lung cancer.
We identified 3455 breast cancer, 3336 colorectal cancer and 2654 lung cancer patients through the Hospital del Mar cancer registry. The prevalence of comorbidities according to the CCI was calculated. Kaplan-Meier curves and the log-rank test were used to compare survival curves for each cancer location. Cox regression was used to calculate survival hazard ratios and 1-, 3- and 5-year mortality rate ratios adjusted by age, sex, CCI, place of first consultation, stage, treatment and period of diagnosis.
The overall unadjusted 5-year follow-up survival proportion was 82.6% for breast cancer, 55.7% for colorectal cancer, and 16.3% for lung cancer. Overall survival was associated with CCI≥3 in breast cancer (HR: 2.33 95%CI: 1.76-3.08), colorectal cancer (HR: 1.39; 95%CI: 1.13-1.70) and lung cancer (HR: 1.22; 95%CI: 1.06-1.40). In breast cancer, the higher the CCI, the higher the adjusted mortality rate ratio and differences were greater in 5-year than in 1-year follow-up survival.
Comorbidity is a significant predictor of overall survival in cancer patients; however, it has a stronger impact on survival in breast cancer than in colorectal and lung cancer.
通过查尔森合并症指数（CCI）评估合并症对乳腺癌、结直肠癌和肺癌患者生存的影响。
我们通过德尔马医院癌症登记处识别出3455例乳腺癌患者、3336例结直肠癌患者和2654例肺癌患者。计算了根据CCI得出的合并症患病率。采用Kaplan-Meier曲线和对数秩检验比较各癌症部位的生存曲线。使用Cox回归计算生存风险比以及经年龄、性别、CCI、首次就诊地点、分期、治疗和诊断时期调整后的1年、3年和5年死亡率比。
乳腺癌未经调整的总体5年随访生存比例为82.6%，结直肠癌为55.7%，肺癌为16.3%。在乳腺癌（HR：2.33；95%CI：1.76 - 3.08）、结直肠癌（HR：1.39；95%CI：1.13 - 1.70）和肺癌（HR：1.22；95%CI：1.06 - 1.40）中，总体生存与CCI≥3相关。在乳腺癌中，CCI越高，调整后的死亡率比越高，5年随访生存的差异比1年随访生存时更大。
合并症是癌症患者总体生存的重要预测因素；然而，它对乳腺癌生存的影响比对结直肠癌和肺癌更强。
