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Chou WC, Chang PH, Lu CH, et al. Effect of Comorbidity on Postoperative Survival Outcomes in Patients with Solid Cancers: A 6-Year Multicenter Study in Taiwan. J Cancer. 2016;7(7):854-61doi: 10.7150/jca.14777.
Chou, W. C., Chang, P. H., Lu, C. H., Liu, K. H., Hung, Y. S., Hung, C. Y., Liu, C. T., Yeh, K. Y., Lin, Y. C., & Yeh, T. S. (2016). Effect of Comorbidity on Postoperative Survival Outcomes in Patients with Solid Cancers: A 6-Year Multicenter Study in Taiwan. Journal of Cancer, 7(7), 854-61. https://doi.org/10.7150/jca.14777
Chou, Wen-Chi, et al. "Effect of Comorbidity on Postoperative Survival Outcomes in Patients with Solid Cancers: A 6-Year Multicenter Study in Taiwan." Journal of Cancer vol. 7,7 (2016): 854-61. doi: https://doi.org/10.7150/jca.14777
Chou WC, Chang PH, Lu CH, Liu KH, Hung YS, Hung CY, Liu CT, Yeh KY, Lin YC, Yeh TS. Effect of Comorbidity on Postoperative Survival Outcomes in Patients with Solid Cancers: A 6-Year Multicenter Study in Taiwan. J Cancer. 2016 Apr 28;7(7):854-61. doi: 10.7150/jca.14777. eCollection 2016. PMID: 27162545; PMCID: PMC4860803.
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J Cancer. 2016 Apr 28;7(7):854-61. doi: 10.7150/jca.14777. eCollection 2016.

Effect of Comorbidity on Postoperative Survival Outcomes in Patients with Solid Cancers: A 6-Year Multicenter Study in Taiwan.

Journal of Cancer

Wen-Chi Chou, Pei-Hung Chang, Chang-Hsien Lu, Keng-Hao Liu, Yu-Shin Hung, Chia-Yen Hung, Chien-Ting Liu, Kun-Yun Yeh, Yung-Chang Lin, Ta-Sen Yeh

Affiliations

  1. 1. Department of Medical Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan;; 2. Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taiwan;
  2. 3. Department of Medical Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan;
  3. 4. Department of Medical Oncology, Chang Gung Memorial Hospital, Keelung, Taiwan;
  4. 5. Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan;
  5. 1. Department of Medical Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan;
  6. 6. Department of Medical Oncology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

PMID: 27162545 PMCID: PMC4860803 DOI: 10.7150/jca.14777

Abstract

PURPOSE: Patients with comorbidities are more likely to experience treatment-related toxicities and death. Our aim was to examine the effect of comorbidity on postoperative survival outcomes in patients with solid cancers.

METHODS: In total, 37,288 patients who underwent potentially curative operations for solid cancers at four affiliated hospitals of the Chang Gung Memorial Hospital, between 2007 and 2012, were stratified according to the Charlson Comorbidity Index (CCI) for postoperative survival analysis. Multivariate Cox regression was used to adjust hazard ratios of survival outcomes among different CCI subgroups.

RESULTS: A significantly greater proportion of patients with comorbidities presented with poorer clinicopathological characteristics compared to those without. After cancer surgery, 26% of patients died after a median follow-up duration of 38.9 months. Overall mortality rates of patients with CCI scores of 0, 1, 2, 3, 4, and 5-8 were 22.9%, 29.5%, 38.2%, 43.2%, 50.2%, and 56.4%, respectively. After adjusting for other clinicopathological factors, patients with increasing CCI scores were associated with significantly reduced overall and noncancer-specific survival rates, while only patients with CCI scores of >2 were associated with higher cancer-specific mortality rates.

CONCLUSIONS: Patients with increasing numbers of comorbidities were associated with reduced postoperative survival outcomes. Patients with multiple comorbidities were most vulnerable to both cancer- and noncancer-specific deaths in the first 6 months after cancer surgery. Our results suggest that for both the patient and clinician, it should be taken into consideration about cancer surgery when dealing with multiple comorbidities.

Keywords: Charlson Comorbidity Index; cancer surger.; comorbidity; postoperative mortality

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