Association of high-risk comorbidity with overall survival among patients with gastric cancer and its sex-specific differences in China: a retrospective observational cohort study

Abstract

Background Concomitant diseases often occur in cancer patients and are important in decision-making regarding treatments. However, information regarding the prognostic relevance of comorbidities for mortality risk is still limited among Chinese gastric cancer (GC) patients. This study aimed to investigate the association between comorbidities and 3-year mortality risk. Methods This retrospective study enrolled 376 GC patients undergoing radical gastrectomy at the Affiliated Zhongshan Hospital of Dalian University from January 2011 to December 2019. Demographic and clinicopathological information and treatment outcomes were collected. Patients were divided into low-, moderate- and high-risk comorbidity groups based on their Charlson Comorbidity Index (CCI) and age-adjusted CCI (ACCI) scores. Kaplan-Meier survival and Cox regression analyses were used to examine 3-year overall survival (OS) and mortality risk for each group. Results The median follow-up time was 43.5 months, and 40.2% (151/376) of GC patients had died at the last follow-up. There were significant differences in OS rates between ACCI-based comorbidity groups (76.56; 64.51; 54.55%, log-rank P = 0.011) but not between CCI-based comorbidity groups (log-rank P = 0.16). The high-risk comorbidity group based on the ACCI remained a significant prognostic factor for 3-year OS in multivariate analysis, with an increased mortality risk (hazard ratio [HR], 1.99; 95% CI, 1.15–3.44). Subgroup analysis revealed that this pattern only held for male GC patients but not for female patients. Conclusion The present study suggested that high-risk comorbidities were significantly associated with a higher mortality risk, particularly in Chinese male GC patients. Moreover, the ACCI score was an independent prognostic factor of long-term mortality.

Effect of Age at Diagnosis on the Prognosis of Gastric Cancer Patients: A Population-Based Study in Georgia

“…Important predictive factors for GC prognosis include tumor patterns at diagnosis and access to effective treatment [2,[7][8][9][10][11]. Significant patient characteristics that can affect GC survival include the patient's age at diagnosis [7,8,[12][13][14][15][16][17][18][19] and the presence of comorbidities [8,20,21]. Elderly patients with gastric cancer are generally recognized as having a worse long-term prognosis than younger patients [3,4,8,12,14,16], but controversies exist regarding the impact of age on cancer-specific mortality [2].…”

A novel model incorporating chromatin regulatory factors for risk stratification, prognosis prediction, and characterization of the microenvironment in Wilms tumor

“…The current therapeutic strategies consist of surgical resection, chemo‐therapy, and radiation ‐therapy. However, because of the complex molecular characteristics of nephroblastoma, the effectiveness of traditional treatment methods is not satisfactory 3 . In the pursuit of improved patient survival rates and enhanced curative outcomes, researchers are actively investigating alternative treatment modalities, such as molecular targeted therapy and immunotherapy, as potential therapeutic avenues.…”