The Prognostic Value of the Age-Adjusted Charlson Comorbidity Index Among the Elderly with Breast Cancer
Zhe Wang, Ying Zhong, Yidong Zhou, Feng Mao, Xiaohui Zhang, Changjun Wang, Qiang Sun Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, People’s Republic of ChinaCorrespondence: Qiang Sun, Email sun...
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| Format: | Article |
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Dove Medical Press
2023-07-01
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| Series: | Clinical Interventions in Aging |
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| Online Access: | https://www.dovepress.com/the-prognostic-value-of-the-age-adjusted-charlson-comorbidity-index-am-peer-reviewed-fulltext-article-CIA |
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| author | Wang Z Zhong Y Zhou Y Mao F Zhang X Wang C Sun Q |
| author_facet | Wang Z Zhong Y Zhou Y Mao F Zhang X Wang C Sun Q |
| author_sort | Wang Z |
| collection | DOAJ |
| description | Zhe Wang, Ying Zhong, Yidong Zhou, Feng Mao, Xiaohui Zhang, Changjun Wang, Qiang Sun Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, People’s Republic of ChinaCorrespondence: Qiang Sun, Email sunqpumch@163.comPurpose: This study aimed to assess the effect of comorbidities on prognosis using the Age-adjusted Charlson Comorbidity Index (ACCI) among the elderly with breast cancer (BC).Methods: This study included 745 patients divided into two groups following the ACCI score (≤ 3 vs > 3). Multivariate logistic regression analysis was conducted for all kinds of outcomes, including BC-specific death (BCSD) and non-breast cancer-specific death (NBCSD). The Kaplan–Meier curves were plotted, and survival analysis was conducted for disease-free survival (DFS), overall survival (OS), BC-specific survival (BCSS), and non-BCSS (NBCSS).Results: A significantly higher NBCSD was found in the high-score (ACCI > 3) group than in the low-score (ACCI < 3) group (p = 0.032). The multivariate logistic regression analysis revealed ACCI score as an independent affecting factor for all-cause death (hazard ratio [HR] = 0.42, 95% confidence interval [CI]: 0.22– 0.83, p = 0.012) and NBCSD (HR = 0.41, 95% CI: 0.20– 0.87, p = 0.020). The Kaplan–Meier curves revealed statistical differences only in NBCSS between the two groups (p = 0.039). Subgroup analysis revealed a worse prognosis in the high-score group for OS and NBCSS among hormone receptor-positive participants and those who without undergoing axillary dissection or receiving chemotherapy (all p < 0.05). Multivariate Cox regression analysis revealed ACCI as an independent prognostic predictor for OS (HR = 2.18, 95% CI: 1.22– 3.92, p = 0.009) and NBCSS (HR = 2.04, 95% CI: 1.02– 4.08, p = 0.044).Conclusion: ACCI was indeed an effective indicator of the effects of comorbidities on survival among elderly patients with BC. However, the co-effect from age and comorbidities was not significant enough on cancer-specific prognosis, although it exerted a significant effect on treatments received.Keywords: comorbidity, elderly, breast cancer, Age-adjusted Charlson Comorbidity Index, prognosis |
| first_indexed | 2024-03-12T21:31:54Z |
| format | Article |
| id | doaj.art-d0f9f39dc4f9429287ab22ef8d2b45e2 |
| institution | Directory Open Access Journal |
| issn | 1178-1998 |
| language | English |
| last_indexed | 2024-03-12T21:31:54Z |
| publishDate | 2023-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Interventions in Aging |
| spelling | doaj.art-d0f9f39dc4f9429287ab22ef8d2b45e22023-07-27T19:14:33ZengDove Medical PressClinical Interventions in Aging1178-19982023-07-01Volume 181163117485443The Prognostic Value of the Age-Adjusted Charlson Comorbidity Index Among the Elderly with Breast CancerWang ZZhong YZhou YMao FZhang XWang CSun QZhe Wang, Ying Zhong, Yidong Zhou, Feng Mao, Xiaohui Zhang, Changjun Wang, Qiang Sun Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, People’s Republic of ChinaCorrespondence: Qiang Sun, Email sunqpumch@163.comPurpose: This study aimed to assess the effect of comorbidities on prognosis using the Age-adjusted Charlson Comorbidity Index (ACCI) among the elderly with breast cancer (BC).Methods: This study included 745 patients divided into two groups following the ACCI score (≤ 3 vs > 3). Multivariate logistic regression analysis was conducted for all kinds of outcomes, including BC-specific death (BCSD) and non-breast cancer-specific death (NBCSD). The Kaplan–Meier curves were plotted, and survival analysis was conducted for disease-free survival (DFS), overall survival (OS), BC-specific survival (BCSS), and non-BCSS (NBCSS).Results: A significantly higher NBCSD was found in the high-score (ACCI > 3) group than in the low-score (ACCI < 3) group (p = 0.032). The multivariate logistic regression analysis revealed ACCI score as an independent affecting factor for all-cause death (hazard ratio [HR] = 0.42, 95% confidence interval [CI]: 0.22– 0.83, p = 0.012) and NBCSD (HR = 0.41, 95% CI: 0.20– 0.87, p = 0.020). The Kaplan–Meier curves revealed statistical differences only in NBCSS between the two groups (p = 0.039). Subgroup analysis revealed a worse prognosis in the high-score group for OS and NBCSS among hormone receptor-positive participants and those who without undergoing axillary dissection or receiving chemotherapy (all p < 0.05). Multivariate Cox regression analysis revealed ACCI as an independent prognostic predictor for OS (HR = 2.18, 95% CI: 1.22– 3.92, p = 0.009) and NBCSS (HR = 2.04, 95% CI: 1.02– 4.08, p = 0.044).Conclusion: ACCI was indeed an effective indicator of the effects of comorbidities on survival among elderly patients with BC. However, the co-effect from age and comorbidities was not significant enough on cancer-specific prognosis, although it exerted a significant effect on treatments received.Keywords: comorbidity, elderly, breast cancer, Age-adjusted Charlson Comorbidity Index, prognosishttps://www.dovepress.com/the-prognostic-value-of-the-age-adjusted-charlson-comorbidity-index-am-peer-reviewed-fulltext-article-CIAcomorbidityelderlybreast cancerage-adjusted charlson comorbidity indexprognosis. |
| spellingShingle | Wang Z Zhong Y Zhou Y Mao F Zhang X Wang C Sun Q The Prognostic Value of the Age-Adjusted Charlson Comorbidity Index Among the Elderly with Breast Cancer Clinical Interventions in Aging comorbidity elderly breast cancer age-adjusted charlson comorbidity index prognosis. |
| title | The Prognostic Value of the Age-Adjusted Charlson Comorbidity Index Among the Elderly with Breast Cancer |
| title_full | The Prognostic Value of the Age-Adjusted Charlson Comorbidity Index Among the Elderly with Breast Cancer |
| title_fullStr | The Prognostic Value of the Age-Adjusted Charlson Comorbidity Index Among the Elderly with Breast Cancer |
| title_full_unstemmed | The Prognostic Value of the Age-Adjusted Charlson Comorbidity Index Among the Elderly with Breast Cancer |
| title_short | The Prognostic Value of the Age-Adjusted Charlson Comorbidity Index Among the Elderly with Breast Cancer |
| title_sort | prognostic value of the age adjusted charlson comorbidity index among the elderly with breast cancer |
| topic | comorbidity elderly breast cancer age-adjusted charlson comorbidity index prognosis. |
| url | https://www.dovepress.com/the-prognostic-value-of-the-age-adjusted-charlson-comorbidity-index-am-peer-reviewed-fulltext-article-CIA |
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