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. 2007 Dec;133(12):945-50.
doi: 10.1007/s00432-007-0233-x. Epub 2007 May 30.

Age, severe comorbidity and functional impairment independently contribute to poor survival in cancer patients

Ulrich Wedding  1 , Bernd Röhrig, Almuth Klippstein, Ludger Pientka, Klaus Höffken
Affiliations

Age, severe comorbidity and functional impairment independently contribute to poor survival in cancer patients

Ulrich Wedding et al. J Cancer Res Clin Oncol. 2007 Dec.

Abstract

Purpose: With the increasing number of elderly patients suffering from cancer, comorbidity and functional impairment become common problems in patients with cancer. Both comorbidity and functional impairment are associated with a shorter survival time in cancer patients, but their independent role has rarely been addressed before.

Methods: Within a prospective trial we recruited 427 cancer patients, irrespective of age and type of cancer, admitted as inpatients prior to the start of chemotherapy. Comorbidity was assessed with the cumulative illness rating scale (CIRS-G), functional impairment with WHO performance status (WHO-PS), basal (ADL) and instrumental (IADL) activities of daily living.

Results: Median follow-up was 34.2 months. A total, 61.4%. of patients died. Median survival time was 21.0 months. Age, kind of tumour (solid vs. haematological), treatment approach (non-curative vs. curative), WHO-PS (2-4 vs. 0-1), IADL (<8 vs. 8), and severe comorbidity (CIRS-level 3-4 vs. none) were significantly associated with shorter survival time in univariate analysis. In a multivariate Cox-regression-analysis, age (HR 1.019; 95%-CI 1.007-1.032; P=0.003), kind of tumour (HR 1.832; 95%-CI 1.314-2.554; P<0.001), WHO-PS (HR 1.455; 95%-CI 1.059-2.000; P=0.021), and comorbidity level 3-4 (HR 1.424; 95%-CI 1.012-2.003; P=0.043) maintained their significant association.

Conclusions: Age, severe comorbidity, functional impairment, and kind of tumour are independently related to shorter survival time in cancer patients.

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Figures

Fig. 1
Fig. 1
Number of patients per diagnosis
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