Wheeler Meghann, Karanth Shama D, Mehta Hiren J, Yang Danting, Aduse-Poku Livingstone, Washington Caretia, Hong Young-Rock, Zhang Dongyu, Gould Michael K, Braithwaite Dejana
Department of Epidemiology, University of Florida College of Public Health and Health Professions, Gainesville, FL 32603, USA.
University of Florida Health Cancer Center, Gainesville, FL 32603, USA.
Cancers (Basel). 2023 Mar 30;15(7):2075. doi: 10.3390/cancers15072075.
We sought to compare overall survival (OS) by comorbidity burden among patients with stage I/II non-small cell lung cancer (NSCLC) who received thoracoscopic resection. Utilizing data from the National Cancer Database, we conducted a survival analysis among patients aged 50+ with stage I/II NSCLC who received thoracoscopic resection between 2010 and 2017. The comorbidity burden was measured by the Charlson comorbidity index (CCI, 0, 1, 2+). Multivariable Cox proportional hazard models were used to compare overall survival relative to the CCI (CCI of 0 as the referent). Subgroup analyses were conducted considering sex, age groups, days from diagnosis to surgery, facility type, laterality, and type of surgery. For this study, 61,760 patients were included, with a mean age of 69.1 years (SD: 8.5). Notably, 51.2% had a CCI of 0, 31.8% had a CCI of 1, and 17.0% had a CCI of 2+. Most participants were non-Hispanic White (87.5%), and 56.9% were female. We found that an increase in the CCI was associated with a higher risk of all-cause mortality (CCI 1 vs. 0 aHR: 1.24, 95% CI: 1.20-1.28; CCI 2+ vs. 0 aHR: 1.51, 95% CI: 1.45-1.57; p-trend < 0.01). Our subgroup analysis according to sex suggested that the association between CCI and risk of death was stronger in women.
我们试图比较接受胸腔镜切除术的Ⅰ/Ⅱ期非小细胞肺癌（NSCLC）患者中，不同合并症负担情况下的总生存期（OS）。利用国家癌症数据库的数据，我们对2010年至2017年间年龄在50岁及以上、接受胸腔镜切除术的Ⅰ/Ⅱ期NSCLC患者进行了生存分析。合并症负担通过Charlson合并症指数（CCI，0、1、2+）来衡量。使用多变量Cox比例风险模型比较相对于CCI（以CCI为0作为参照）的总生存期。根据性别、年龄组、从诊断到手术的天数、医疗机构类型、手术侧别和手术类型进行亚组分析。本研究纳入了61760例患者，平均年龄为69.1岁（标准差：8.5）。值得注意的是，51.2%的患者CCI为0，31.8%的患者CCI为1，17.0%的患者CCI为2+。大多数参与者为非西班牙裔白人（87.5%），56.9%为女性。我们发现，CCI升高与全因死亡率风险增加相关（CCI 1与0相比，调整后风险比[aHR]：1.24，95%置信区间[CI]：1.20 - 1.28；CCI 2+与0相比，aHR：1.51，95% CI：1.45 - 1.57；P趋势<0.01）。我们根据性别的亚组分析表明，CCI与死亡风险之间的关联在女性中更强。
