Division of Gastric Surgery, Shizuoka Cancer Center, Japan.
Division of Gastric Surgery, Shizuoka Cancer Center, Japan.
Eur J Surg Oncol. 2021 Aug;47(8):2010-2015. doi: 10.1016/j.ejso.2021.01.026. Epub 2021 Jan 30.
The current study aimed to evaluate the ability of a modified version of the age-adjusted Charlson Comorbidity Index (mACCI) in predicting cause-specific survival (CSS) among patients with gastric cancer who underwent curative gastrectomy and compared it with the conventional ACCI.
Patients who underwent gastrectomy for gastric cancer from 2007 to 2016 (n = 2885) were included. A mACCI was established by excluding scores for other malignancies, such as other cancers, leukemia, and lymphoma. After determining the optimal cutoff ACCI and mACCI values for CSS, clinicopathological factors and survival outcomes were assessed according to the ACCI and mACCI.
Both ACCI and mACCI were identified as independent prognostic factors for overall survival (p < 0.001 and p < 0.001, respectively). However, only mACCI was identified as an independent prognostic factor for CSS (p < 0.001). The present study suggested that mACCI was a better indicator of CSS in patients with gastric cancer who underwent curative gastrectomy than ACCI.
Our findings showed that the mACCI was a strong predictor of CSS in patients with gastric cancer who underwent curative gastrectomy. We believe that the mACCI will become a novel marker that would guide treatment decisions for patients with gastric cancer suffering from comorbidities.
本研究旨在评估改良年龄调整 Charlson 合并症指数（mACCI）在预测接受根治性胃切除术的胃癌患者的特定原因生存（CSS）方面的能力，并与传统的 ACCI 进行比较。
纳入 2007 年至 2016 年接受胃切除术治疗胃癌的患者（n=2885）。通过排除其他恶性肿瘤（如其他癌症、白血病和淋巴瘤）的评分，建立 mACCI。确定 CSS 的最佳 ACCI 和 mACCI 截断值后，根据 ACCI 和 mACCI 评估临床病理因素和生存结局。
ACCI 和 mACCI 均被确定为总生存的独立预后因素（p<0.001 和 p<0.001）。然而，只有 mACCI 被确定为 CSS 的独立预后因素（p<0.001）。本研究表明，mACCI 是接受根治性胃切除术的胃癌患者 CSS 的更好指标。
我们的研究结果表明，mACCI 是接受根治性胃切除术的胃癌患者 CSS 的有力预测指标。我们相信，mACCI 将成为指导患有合并症的胃癌患者治疗决策的新标志物。
