Impact of Comorbidities on Survival in Gastric, Colorectal, and Lung Cancer Patients
Background: The presence of comorbidities in cancer patients may influence treatment decisions and prognoses. This study aimed to examine the impact of comorbidities on overall survival in Japanese patients diagnosed with major solid tumors. Methods: To obtain patient-level information on clinical c...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Japan Epidemiological Association
2019-03-01
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| Series: | Journal of Epidemiology |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/jea/29/3/29_JE20170241/_pdf |
| _version_ | 1819023644136833024 |
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| author | Toshitaka Morishima Yoshifumi Matsumoto Nobuyuki Koeda Hiroko Shimada Tsutomu Maruhama Daisaku Matsuki Kayo Nakata Yuri Ito Takahiro Tabuchi Isao Miyashiro |
| author_facet | Toshitaka Morishima Yoshifumi Matsumoto Nobuyuki Koeda Hiroko Shimada Tsutomu Maruhama Daisaku Matsuki Kayo Nakata Yuri Ito Takahiro Tabuchi Isao Miyashiro |
| author_sort | Toshitaka Morishima |
| collection | DOAJ |
| description | Background: The presence of comorbidities in cancer patients may influence treatment decisions and prognoses. This study aimed to examine the impact of comorbidities on overall survival in Japanese patients diagnosed with major solid tumors. Methods: To obtain patient-level information on clinical conditions and vital status, we performed a record linkage of population-based cancer registry data from Osaka Prefecture, Japan and administrative data produced under the Diagnosis Procedure Combination (DPC) system. The study population comprised patients who received a primary diagnosis of gastric, colorectal, or lung cancer between 2010 and 2012 at any of five cancer centers. We employed the Charlson Comorbidity Index (CCI) score to quantify the impact of comorbidities on survival. The association between CCI score and survival for each cancer site was analyzed using Cox proportional hazards regression models for all-cause mortality, after adjusting for patient sex, age at cancer diagnosis, and cancer stage. Results: A total of 2,609 patients with a median follow-up duration of 1,372 days were analyzed. The most frequent CCI score among the patients was 0 (77.7%), followed by 2 (14.3%). After adjusting for the covariates, we detected a significant association between CCI score and all-cause mortality. The hazard ratios per one-point increase in CCI score were 1.12 (95% confidence interval [CI], 1.02–1.23), 1.20 (95% CI, 1.08–1.34), and 1.14 (95% CI, 1.04–1.24) for gastric, colorectal, and lung cancer, respectively. Conclusions: Comorbidities have a negative prognostic impact on overall survival in cancer patients, and should be assessed as risk factors for mortality when reporting outcomes. |
| first_indexed | 2024-12-21T04:42:10Z |
| format | Article |
| id | doaj.art-d3e2c176d9e341888294d8b94a9f0232 |
| institution | Directory Open Access Journal |
| issn | 0917-5040 1349-9092 |
| language | English |
| last_indexed | 2024-12-21T04:42:10Z |
| publishDate | 2019-03-01 |
| publisher | Japan Epidemiological Association |
| record_format | Article |
| series | Journal of Epidemiology |
| spelling | doaj.art-d3e2c176d9e341888294d8b94a9f02322022-12-21T19:15:40ZengJapan Epidemiological AssociationJournal of Epidemiology0917-50401349-90922019-03-0129311011510.2188/jea.JE20170241Impact of Comorbidities on Survival in Gastric, Colorectal, and Lung Cancer PatientsToshitaka Morishima0Yoshifumi Matsumoto1Nobuyuki Koeda2Hiroko Shimada3Tsutomu Maruhama4Daisaku Matsuki5Kayo Nakata6Yuri Ito7Takahiro Tabuchi8Isao Miyashiro9Cancer Control Center, Osaka International Cancer Institute, Osaka, JapanCancer Control Center, Osaka International Cancer Institute, Osaka, JapanYao Municipal Hospital, Osaka, JapanNational Hospital Organization Osaka Minami Medical Center, Osaka, JapanHigashisumiyoshi Morimoto Hospital, Osaka, JapanSaiseikai Suita Hospital, Osaka, JapanCancer Control Center, Osaka International Cancer Institute, Osaka, JapanCancer Control Center, Osaka International Cancer Institute, Osaka, JapanCancer Control Center, Osaka International Cancer Institute, Osaka, JapanCancer Control Center, Osaka International Cancer Institute, Osaka, JapanBackground: The presence of comorbidities in cancer patients may influence treatment decisions and prognoses. This study aimed to examine the impact of comorbidities on overall survival in Japanese patients diagnosed with major solid tumors. Methods: To obtain patient-level information on clinical conditions and vital status, we performed a record linkage of population-based cancer registry data from Osaka Prefecture, Japan and administrative data produced under the Diagnosis Procedure Combination (DPC) system. The study population comprised patients who received a primary diagnosis of gastric, colorectal, or lung cancer between 2010 and 2012 at any of five cancer centers. We employed the Charlson Comorbidity Index (CCI) score to quantify the impact of comorbidities on survival. The association between CCI score and survival for each cancer site was analyzed using Cox proportional hazards regression models for all-cause mortality, after adjusting for patient sex, age at cancer diagnosis, and cancer stage. Results: A total of 2,609 patients with a median follow-up duration of 1,372 days were analyzed. The most frequent CCI score among the patients was 0 (77.7%), followed by 2 (14.3%). After adjusting for the covariates, we detected a significant association between CCI score and all-cause mortality. The hazard ratios per one-point increase in CCI score were 1.12 (95% confidence interval [CI], 1.02–1.23), 1.20 (95% CI, 1.08–1.34), and 1.14 (95% CI, 1.04–1.24) for gastric, colorectal, and lung cancer, respectively. Conclusions: Comorbidities have a negative prognostic impact on overall survival in cancer patients, and should be assessed as risk factors for mortality when reporting outcomes.https://www.jstage.jst.go.jp/article/jea/29/3/29_JE20170241/_pdfadministrative claims datacomorbiditymedical record linkageneoplasmssurvival analysis |
| spellingShingle | Toshitaka Morishima Yoshifumi Matsumoto Nobuyuki Koeda Hiroko Shimada Tsutomu Maruhama Daisaku Matsuki Kayo Nakata Yuri Ito Takahiro Tabuchi Isao Miyashiro Impact of Comorbidities on Survival in Gastric, Colorectal, and Lung Cancer Patients Journal of Epidemiology administrative claims data comorbidity medical record linkage neoplasms survival analysis |
| title | Impact of Comorbidities on Survival in Gastric, Colorectal, and Lung Cancer Patients |
| title_full | Impact of Comorbidities on Survival in Gastric, Colorectal, and Lung Cancer Patients |
| title_fullStr | Impact of Comorbidities on Survival in Gastric, Colorectal, and Lung Cancer Patients |
| title_full_unstemmed | Impact of Comorbidities on Survival in Gastric, Colorectal, and Lung Cancer Patients |
| title_short | Impact of Comorbidities on Survival in Gastric, Colorectal, and Lung Cancer Patients |
| title_sort | impact of comorbidities on survival in gastric colorectal and lung cancer patients |
| topic | administrative claims data comorbidity medical record linkage neoplasms survival analysis |
| url | https://www.jstage.jst.go.jp/article/jea/29/3/29_JE20170241/_pdf |
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