Prevalence and prognostic impact of comorbidities and peripheral blood indices in sarcomas
Background The prognostic impact of comorbidities in patients with sarcomas is not well defined. The aims of this study were to examine the implications of comorbidities and abnormal peripheral blood indices in patients with sarcomas.Methods A population-based database was assembled to extract patie...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-12-01
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| Series: | ESMO Open |
| Online Access: | https://esmoopen.bmj.com/content/5/6/e001035.full |
| _version_ | 1819052886399647744 |
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| author | Teresa Tse Carlos King Ho Wong Herbert Ho-fung Loong Yihui Wei Sampson Sui Chun Kwan Yingjun Zhang Yat-Ming Lau Linda K S Leung Gordon C H Tang |
| author_facet | Teresa Tse Carlos King Ho Wong Herbert Ho-fung Loong Yihui Wei Sampson Sui Chun Kwan Yingjun Zhang Yat-Ming Lau Linda K S Leung Gordon C H Tang |
| author_sort | Teresa Tse |
| collection | DOAJ |
| description | Background The prognostic impact of comorbidities in patients with sarcomas is not well defined. The aims of this study were to examine the implications of comorbidities and abnormal peripheral blood indices in patients with sarcomas.Methods A population-based database was assembled to extract patients with sarcoma in Hong Kong between January 2004 and March 2018. Charlson’s Comorbidity Index (CCI) score and prevalence of comorbidities, neutrophil, lymphocyte and platelet counts at diagnosis were assessed. The prognostic values of CCI, neutrophil-lymphocyte (NLR) and platelet-lymphocyte ratios (PLR) were estimated using Cox proportional hazard models. Restricted cubic spline plots were used to explore the association of baseline NLR and PLR with all-cause and cancer-specific mortality.Results Among 3358 eligible patients with sarcomas, 52.2% died after a median 26 months of follow-up. The most common comorbidities were diabetes mellitus (9.8%) and cerebrovascular disease (4.8%). Patients with higher CCI had higher mortality (CCI=3 vs CCI=2; HR 1.49; 95% CI 1.19 to 1.87; p<0.01; CCI ≥7 vs CCI =2; HR 3.20; 95% CI 2.62 to 3.92; p<0.001). Abnormal NLR and PLR levels were associated with higher all-cause mortality (NLR: HR 1.698, p<0.001, 95% CI 1.424 to 2.025; PLR: HR 1.346, p<0.001, 95% CI 1.164 to 1.555) and cancer-related mortality (NLR: HR 1.648, p<0.001, 95% CI 1.341 to 2.024; PLR: HR 1.430, p<0.001, 95% CI 1.205 to 1.697).Conclusions This is the largest population-based soft-tissue or bone sarcoma cohort worldwide. Comorbidities have significant negative prognostic impact on the survival of patients with sarcomas. Moreover, NLR and PLR are robust prognostic factors, and abnormal NLR and PLR have negative effects yet non-linear effects on survival. |
| first_indexed | 2024-12-21T12:26:57Z |
| format | Article |
| id | doaj.art-11c3d34c473c48dba9509ec81618e2e3 |
| institution | Directory Open Access Journal |
| issn | 2059-7029 |
| language | English |
| last_indexed | 2024-12-21T12:26:57Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | ESMO Open |
| spelling | doaj.art-11c3d34c473c48dba9509ec81618e2e32022-12-21T19:04:08ZengElsevierESMO Open2059-70292020-12-015610.1136/esmoopen-2020-001035Prevalence and prognostic impact of comorbidities and peripheral blood indices in sarcomasTeresa Tse0Carlos King Ho Wong1Herbert Ho-fung Loong2Yihui Wei3Sampson Sui Chun Kwan4Yingjun Zhang5Yat-Ming Lau6Linda K S Leung7Gordon C H Tang8Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong SAR, ChinaDepartment of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong, ChinaDepartment of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong SAR, ChinaDepartment of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, ChinaFaculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, ChinaDepartment of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong SAR, ChinaDepartment of Clinical Oncology, Prince of Wales Hospital, Hong Kong SAR, ChinaDepartment of Clinical Oncology, Prince of Wales Hospital, Hong Kong SAR, ChinaDepartment of Clinical Oncology, Prince of Wales Hospital, Hong Kong SAR, ChinaBackground The prognostic impact of comorbidities in patients with sarcomas is not well defined. The aims of this study were to examine the implications of comorbidities and abnormal peripheral blood indices in patients with sarcomas.Methods A population-based database was assembled to extract patients with sarcoma in Hong Kong between January 2004 and March 2018. Charlson’s Comorbidity Index (CCI) score and prevalence of comorbidities, neutrophil, lymphocyte and platelet counts at diagnosis were assessed. The prognostic values of CCI, neutrophil-lymphocyte (NLR) and platelet-lymphocyte ratios (PLR) were estimated using Cox proportional hazard models. Restricted cubic spline plots were used to explore the association of baseline NLR and PLR with all-cause and cancer-specific mortality.Results Among 3358 eligible patients with sarcomas, 52.2% died after a median 26 months of follow-up. The most common comorbidities were diabetes mellitus (9.8%) and cerebrovascular disease (4.8%). Patients with higher CCI had higher mortality (CCI=3 vs CCI=2; HR 1.49; 95% CI 1.19 to 1.87; p<0.01; CCI ≥7 vs CCI =2; HR 3.20; 95% CI 2.62 to 3.92; p<0.001). Abnormal NLR and PLR levels were associated with higher all-cause mortality (NLR: HR 1.698, p<0.001, 95% CI 1.424 to 2.025; PLR: HR 1.346, p<0.001, 95% CI 1.164 to 1.555) and cancer-related mortality (NLR: HR 1.648, p<0.001, 95% CI 1.341 to 2.024; PLR: HR 1.430, p<0.001, 95% CI 1.205 to 1.697).Conclusions This is the largest population-based soft-tissue or bone sarcoma cohort worldwide. Comorbidities have significant negative prognostic impact on the survival of patients with sarcomas. Moreover, NLR and PLR are robust prognostic factors, and abnormal NLR and PLR have negative effects yet non-linear effects on survival.https://esmoopen.bmj.com/content/5/6/e001035.full |
| spellingShingle | Teresa Tse Carlos King Ho Wong Herbert Ho-fung Loong Yihui Wei Sampson Sui Chun Kwan Yingjun Zhang Yat-Ming Lau Linda K S Leung Gordon C H Tang Prevalence and prognostic impact of comorbidities and peripheral blood indices in sarcomas ESMO Open |
| title | Prevalence and prognostic impact of comorbidities and peripheral blood indices in sarcomas |
| title_full | Prevalence and prognostic impact of comorbidities and peripheral blood indices in sarcomas |
| title_fullStr | Prevalence and prognostic impact of comorbidities and peripheral blood indices in sarcomas |
| title_full_unstemmed | Prevalence and prognostic impact of comorbidities and peripheral blood indices in sarcomas |
| title_short | Prevalence and prognostic impact of comorbidities and peripheral blood indices in sarcomas |
| title_sort | prevalence and prognostic impact of comorbidities and peripheral blood indices in sarcomas |
| url | https://esmoopen.bmj.com/content/5/6/e001035.full |
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