학술논문

Impact of comorbidity on renal cell carcinoma prognosis: a nationwide cohort study.
Document Type
Article
Source
Acta Oncologica. Jan 2022, Vol. 61 Issue 1, p58-63. 6p. 4 Charts, 1 Graph.
Subject
*RENAL cell carcinoma
*CONFIDENCE intervals
*LIVER diseases
*DESCRIPTIVE statistics
*QUESTIONNAIRES
*DEMENTIA
*COMORBIDITY
*LONGITUDINAL method
*PROPORTIONAL hazards models
*DISEASE complications
MORTALITY risk factors
Language
ISSN
0284-186X
Abstract
Presence of comorbid diseases at time of cancer diagnosis may affect prognosis. We evaluated the impact of comorbidity on survival of patients diagnosed with renal cell carcinoma (RCC), overall and among younger (<70 years) and older (≥70 years) patients. We established a nationwide register-based cohort of 7894 patients aged ≥18 years diagnosed with RCC in Denmark between 2006 and 2017. We computed 1- and 5-year overall survival and hazard ratios (HRs) for death according to the Charlson Comorbidity Index (CCI) score. Survival decreased with increasing CCI score despite an overall increase in survival over time. The 5-year survival rate of patients with no comorbidity increased from 57% among those diagnosed in 2006–2008 to 69% among those diagnosed in 2012–2014. During the same periods, the survival rate increased from 46% to 62% among patients with a CCI score of 1–2 and from 39% to 44% for those with a CCI score of ≥3. Patients with CCI scores of 1–2 and ≥3 had higher mortality rates than patients with no registered comorbidity (HR 1.15, 95% CI 1.06–1.24 and HR 1.56, 95% CI 1.40–1.73). Patterns were similar for older and younger patients. Particularly, diagnoses of liver disease (HR 2.09, 95% CI 1.53–2.84 and HR 4.01, 95% CI 2.44–6.56) and dementia (HR 2.16, 95% CI 1.34–3.48) increased mortality. Comorbidity decreased the survival of patients with RCC, irrespective of age, despite an overall increasing survival over time. These results highlight the importance of focusing on comorbidity in this group of patients. [ABSTRACT FROM AUTHOR]