Department of Radiation Oncology, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
Department of Clinical Research and Statistics, Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
Asian Pac J Cancer Prev. 2023 Nov 1;24(11):3805-3814. doi: 10.31557/APJCP.2023.24.11.3805.
To report comorbidity burden in newly-diagnosed treatment-naïve breast cancer patients and its effect on survival.
Prospective observational study in which demographic, comorbidity and outcome data from a consecutive cohort of patients diagnosed and treated between September 2019 to September 2021 were collected. Charlson Comorbidity Index (CCI) score was calculated for all and proportion of each comorbidity was determined at diagnosis (baseline), at conclusion and six-months post-treatment. Univariate and multivariate analysis was done for impact of various demographic and disease-related factors on the incidence of comorbidities as well as on progression free survival (PFS) and overall survival (OS).
Out of five hundred patients who consented for the study, 416 patients completed planned treatment and only 206 patients had physical follow-up due to COVID-19 pandemic. Incidence of comorbidity at the three time-points was 24%, 32% and 26% respectively. The difference was significant compared to baseline at both the time-points (p<0.05). Hypertension and diabetes were the most common types (incidence 15%-21% and 12-18% respectively) of comorbidities. Advancing age, post-menopauusal status and not being married were significant factors for presence of comorbidities. Median follow-up was 27 months (95% CI 26.25-28.55 months). Presence of multiple comorbidities was a poor prognostic factor for both PFS (2-yr PFS 85% vs 77%) and OS (2-yr OS 89% vs 79%) (both p=0.04) but no such correlation for CCI score.
Breast cancer treatment impacted incidence of comorbidities. Presence of multiple comorbidities had an adverse impact on survival. Hence, further research on treatment optimization is required in patients with substantial comorbidities.
报告新诊断的未经治疗的乳腺癌患者的合并症负担及其对生存的影响。
这是一项前瞻性观察性研究，收集了 2019 年 9 月至 2021 年 9 月连续队列中患者的人口统计学、合并症和结局数据。为所有患者计算 Charlson 合并症指数（CCI）评分，并确定在诊断（基线）、治疗结束时和治疗后 6 个月时每种合并症的比例。对各种人口统计学和疾病相关因素对合并症发生率以及无进展生存期（PFS）和总生存期（OS）的影响进行单因素和多因素分析。
在同意参加这项研究的 500 名患者中，有 416 名患者完成了计划治疗，由于 COVID-19 大流行，只有 206 名患者进行了身体随访。在三个时间点，合并症的发生率分别为 24%、32%和 26%。与基线相比，这两个时间点的差异均有统计学意义（p<0.05）。高血压和糖尿病是最常见的合并症类型（发生率分别为 15%-21%和 12-18%）。年龄增长、绝经后状态和未婚是合并症存在的显著因素。中位随访时间为 27 个月（95%CI 26.25-28.55 个月）。存在多种合并症是 PFS（2 年 PFS 85% vs 77%）和 OS（2 年 OS 89% vs 79%）的不良预后因素（均 p=0.04），但 CCI 评分无此相关性。
乳腺癌治疗会影响合并症的发生。存在多种合并症对生存有不利影响。因此，需要对合并症较多的患者进行进一步的治疗优化研究。
