Niedersüß-Beke Dora, Orlinger Manuel, Falch David, Heiler Cordula, Piringer Gudrun, Thaler Josef, Hilbe Wolfgang, Petzer Andreas, Rumpold Holger
Department of Internal Medicine I, Wilhelminenspital, 1160 Vienna, Austria.
Department of Hematology and Medical Oncology, Ordensklinikum Linz, 4010 Linz, Austria.
Cancers (Basel). 2021 Apr 26;13(9):2091. doi: 10.3390/cancers13092091.
We aimed to investigate the effectiveness of oncological treatments in metastatic CRC related to comorbidities and age. This retrospective study included 1105 patients from three oncological centers. aaCCI and CCI was available from 577 patients. An aaCCI > 3 was of the highest predictive value compared to other aaCCI-levels, CCI or age ( < 0.001 for all). Treatment (best supportive care (BSC), systemic treatment only (STO) and resection of metastases (ROM)) significantly prolonged survival in patients with aaCCI > 3 (STO: HR 0.39, CI 0.29-0.51; ROM: HR 0.16, CI 0.10-0.24) and patients older than 70 years (STO: HR 0.56, CI 0.47-0.66; ROM: HR 0.23, 0.18-0.30). Median overall survival was shorter in patients with aaCCI or age > 70 years and interaction for treatment type not significant for aaCCI, but significant for age older or younger than 70 years (STO: = 0.01; ROM = 0.02). BSC is more often considered as optimal care for patients with an aaCCI > 3 (37.6% vs. 12.4%; < 0.001) or age > 70 years (35.7% vs. 11.2%; < 0.001). Older patients or patients with comorbidities benefit from cancer-specific therapy independently of their age and comorbidities.
我们旨在研究肿瘤治疗对合并症及年龄相关的转移性结直肠癌的有效性。这项回顾性研究纳入了来自三个肿瘤中心的1105例患者。577例患者可获得年龄调整 Charlson 共病指数(aaCCI)和 Charlson 共病指数(CCI)。与其他aaCCI水平、CCI或年龄相比,aaCCI>3具有最高的预测价值(所有比较P<0.001)。治疗(最佳支持治疗(BSC)、单纯全身治疗(STO)和转移灶切除术(ROM))显著延长了aaCCI>3患者的生存期(STO:风险比(HR)0.39,置信区间(CI)0.29 - 0.51;ROM:HR 0.16,CI 0.10 - 0.24)以及70岁以上患者的生存期(STO:HR 0.56,CI 0.47 - 0.66;ROM:HR 0.23,0.18 - 0.30)。aaCCI或年龄>70岁患者的中位总生存期较短,治疗类型的交互作用对aaCCI不显著,但对70岁以上或以下年龄组显著(STO:P = 0.01;ROM:P = 0.02)。对于aaCCI>3(37.6%对12.4%;P<0.001)或年龄>70岁(35.7%对11.2%;P<0.001)的患者,BSC更常被视为最佳治疗。老年患者或合并症患者可从癌症特异性治疗中获益,而与他们的年龄和合并症无关。