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. 2015 Jan;94(2):e431.
doi: 10.1097/MD.0000000000000431.

Age-adjusted Charlson comorbidity index scores as predictor of survival in colorectal cancer patients who underwent surgical resection and chemoradiation

Chin-Chia Wu  1 , Ta-Wen Hsu, Chun-Ming Chang, Chia-Hui Yu, Ching-Chih Lee
Affiliations

Age-adjusted Charlson comorbidity index scores as predictor of survival in colorectal cancer patients who underwent surgical resection and chemoradiation

Chin-Chia Wu et al. Medicine (Baltimore). 2015 Jan.

Abstract

We studied the effect of Age-Adjusted Comorbidity Index Score in colorectal cancer patients who underwent similarly aggressive treatment. Using the National Health Insurance Research Database of Taiwan, we identified 5643 patients with colorectal cancer who underwent surgical resection and chemoradiation from 2007 through 2011. We estimated survival according to Age-Adjusted Comorbidity Index Scores and 5-year survival using Cox proportional hazard regression analysis, adjusting for sex, oxaliplatin-based chemotherapy, socioeconomic status, geographic region, and hospital characteristics. In the cohort were 3230 patients with colonic cancer and 2413 patients with rectal cancer, who had undergone combined surgical resection and either neoadjuvant or adjuvant chemoradiation. After adjusting for patient characteristics (sex, oxaliplatin-based chemotherapy, socioeconomic status, geographic region, and hospital-characteristics), colonic cancer patients with age-adjusted Charlson (AAC) ≥ 6 had a 106% greater risk of death within 5 years (adjusted HR = 2.06; 95% CI, 1.66-2.56). In rectal cancer patients, patients with an AAC score of 4-5 had a 28% greater risk of death within 5 years (adjusted HR = 1.28; 95% CI, 1.02-1.61), and those with AAC ≥ 6 had a 47% greater risk (adjusted HR = 1.47; 95% CI, 1.15-1.90). Age and burden of comorbidities influence survival of patients with colonic or rectal cancer. Age-Adjusted Comorbidity Score remains an independent prognostic factor even after adjusting for the aggressiveness of treatment.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Patient selection flowchart. ICD-9 = International Classification of Disease, Ninth Revision.
Figure 2
Figure 2
(A) The survival of colonic cancer patients who underwent surgical resection and chemoradiation according to different Age-Adjusted Charlson Comorbidity Index Scores. (B) The survival of rectal cancer patients who underwent surgical resection and chemoradiation according to different Age-Adjusted Charlson Comorbidity Index Scores. AAC = age-adjusted Charlson (AAC).
See this image and copyright information in PMC

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