Fu Alex Z, Zhao Zhongyun, Gao Sue, Barber Beth, Liu Gordon G
Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA.
Amgen Inc, One Amgen Center Drive, Thousand Oaks, CA 91320-1799, USA.
World J Oncol. 2011 Oct;2(5):225-231. doi: 10.4021/wjon370e. Epub 2011 Oct 28.
Patients with metastatic colorectal cancer (mCRC) often have other medical conditions that may impact treatment decisions, prognoses and quality of care. We aimed to assess co-existing medical conditions in the mCRC patient population. This retrospective cohort study used linked medical and pharmacy claims data from two US-based Medstat MarketScan claims databases and identified patients with newly diagnosed mCRC between January 2005 and June 2008.
Patient data were analyzed for comorbid conditions and medication use in the year prior to diagnosis of mCRC. Univariate analyses were conducted to compare the comorbid conditions between patients aged ≥ 65 and < 65 years old. In total, 12 648 patients aged ≥ 18 years were identified. The study was evenly populated by gender and age above and below 65, and most patients had a primary diagnosis of colon cancer (70.1%).
The most prevalent comorbidity was cardiovascular disease (CVD) (55.7% of patients) including hypertension (40.8%), cardiac dysrhythmia (14.2%), coronary artery disease (13.5%), congestive heart failure (7.2%) and arterial and venous thromboembolism (6.2% and 4.6%, respectively). Most comorbidities were significantly more prevalent in patients ≥ 65 years of age, particularly with respect to CVD (67.9% versus 42.5%, respectively; P < 0.0001). Additionally, nearly half (49.7%) of the patients received antihypertensive agents and many patients were prescribed more than one class of medications prior to mCRC diagnosis.
Comorbid medical conditions, particularly CVDs, are common in patients with mCRC, which could increase the complexity of patient management. This should be a consideration integral to the selection of the most appropriate treatment for individual patients.
转移性结直肠癌(mCRC)患者通常还患有其他疾病,这些疾病可能会影响治疗决策、预后和医疗质量。我们旨在评估mCRC患者群体中并存的疾病情况。这项回顾性队列研究使用了来自美国两个基于Medstat MarketScan理赔数据库的关联医疗和药房理赔数据,确定了2005年1月至2008年6月期间新诊断为mCRC的患者。
分析患者在mCRC诊断前一年的合并症情况和用药情况。进行单因素分析以比较年龄≥65岁和<65岁患者之间的合并症情况。总共确定了12648名年龄≥18岁的患者。该研究在性别以及65岁上下的年龄分布上较为均衡,大多数患者的原发性诊断为结肠癌(70.1%)。
最常见的合并症是心血管疾病(CVD)(占患者的55.7%),包括高血压(40.8%)、心律失常(14.2%)、冠状动脉疾病(13.5%)、充血性心力衰竭(7.2%)以及动脉和静脉血栓栓塞(分别为6.2%和4.6%)。大多数合并症在≥65岁的患者中更为普遍,尤其是CVD(分别为67.9%和42.5%;P<0.0001)。此外,近一半(49.7%)的患者接受了抗高血压药物治疗,并且许多患者在mCRC诊断前被开具了不止一类药物。
合并的疾病情况,尤其是CVD,在mCRC患者中很常见,这可能会增加患者管理的复杂性。这应成为为个体患者选择最合适治疗方法时不可或缺的考虑因素。