Impact of the Age-adjusted Charlson comorbidity index on the short- and long-term outcomes of patients undergoing curative gastrectomy for gastric cancer

Maezawa, Yukio; Aoyama, Toru; Kano, Kazuki; Numata, Masakatsu; Hara, Kentaro; Murakawa, Masaaki; Yamada, Takanobu; Sato, Tsutomu; Ogata, Takashi; Oshima, Takashi; Yukawa, Norio; Yoshikawa, Takaki; Masuda, Munetaka; Rino, Yasushi

doi:10.7150/jca.35465

Cited by 39 publications

(36 citation statements)

References 33 publications

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“…The relationship between increased prevalence of comorbidities and deleterious outcome in cancer patients has been analyzed in various tumor entities [ 19 , 20 ]. For cutaneous malignant melanoma, a comprehensive cancer registry-based study on a Danish population revealed more advanced tumor stages to be prevalent in patients with increased comorbidity levels [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Head and neck melanoma: outcome and predictors in a population-based cohort study

et al. 2021

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Background To evaluate predictive clinico-pathological characteristics on outcome in head and neck melanoma (HNM) in a population-based study with particular emphasis on the prognostic effect of sentinel lymph node biopsy (SLNB), Charlson comorbidity index (CCI) and distinct tumor localisations. Methods Here we primarily describe a retrospective multicenter population-based cohort study with 402 patients having undergone resection with curative intent of HNM between 2010 and 2017. SLNB was used in the diagnosis of 79 HNM patients. Outcome was analyzed, focusing on SLNB, CCI as well as tumor localisation. Overall survival (OAS) und recurrence free survival (RFS) was examined by uni- and multivariate analysis. Results Histopathologically verified lymph node metastasis according to SLNB was associated with impaired RFS in HNM patients (p = 0.004). Especially in higher tumor stages, the sole implementation of SLNB improved survival significantly in the present cohort (p = 0.042). With most of the HNM being located in the face, melanoma of the scalp and neck could be linked to deteriorated patient’s outcome in uni- as well as multivariate analysis (p = 0.021, p = 0.004). Conclusions SLNB is a useful tool in predicting development of distant metastasis after HNM resection with curative intent. Especially in higher tumor stages, performing a SLNB ameliorated survival of HNM patients. Additionally, CCI as well as a distinct tumor localisations in HNM were identified as important risk factors in our population-based cohort study.

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Section: Discussionmentioning

confidence: 99%

Head and neck melanoma: outcome and predictors in a population-based cohort study

et al. 2021

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“…A few studies have described the relationship between ACCI and survival for gastrointestinal cancer patients. Maezawa et al investigated the survival impacts of ACCI in 2254 patients who received radical gastrectomy for gastric cancer (17). They divided the patients into two groups: low-ACCI group (n=1656) and high-ACCI group (n=598).…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have previously explored the appropriate cut-off value of ACCI in several cancers. In the gastrointestinal region, Lin et al set 3 as the cut-off value in 1476 gastric cancer patients, and Maezawa et al set 6 as the cut-off value in 2254 gastric cancer patients (17,18). In the hepato-biliary pancreatic cancer region, Qu et al set 4 as the cut-off value in 268 intrahepatic cholangiocarcinoma patients, and Takahara et al set 5 as the cut-off value in biliary tract cancer (22,23).…”

Section: Discussionmentioning

confidence: 99%

The Clinical Impact of the Age-adjusted Charlson Comorbidity Index on Esophageal Cancer Patients Who Receive Curative Treatment

Aoyama

Atsumi

Kawahara

et al. 2020

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Background/Aim: We investigated the impact of the age-adjusted Charlson comorbidity index (ACCI) on esophageal cancer survival and recurrence after curative treatment. Patients and Methods: This study included 122 patients who underwent curative surgery followed by adjuvant chemotherapy for esophageal cancer between 2005 and 2017. The risk factors for the overall survival (OS) and recurrencefree survival (RFS) were identified. Results: An ACCI of 5 was regarded as the optimal critical point of classification considering the survival rates. The OS rates at 3 and 5 years after surgery were 64.2% and 54.4% in the low-ACCI group, respectively, and 42.3% and 29.2% in high-ACCI group, respectively (p=0.035). The RFS rates at 3 and 5 years after surgery were 50.2% and 43.6% in the low-ACCI group, respectively, and 28.5% and 21.3% in high-ACCI group, respectively (p=0.021). A multivariate analysis demonstrated that ACCI was a significant independent risk factor for both the OS and RFS. Conclusion: ACCI is a risk factor for survival in patients who undergo curative treatment for esophageal cancer. An effective plan for the perioperative care and surgical strategy should be developed according to ACCI. Esophageal cancer is the seventh-most common cancer and the sixth leading cause of cancer-related mortality. An 2783 This article is freely accessible online.

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“…These results indicated that some post-ESD elderly patients can benefit from additional treatment. Several studies have clarified the relationship between CCI and complications of elderly gastric patients after ESD, which showed CCI can serve as an independent prognostic factor (12,(19)(20)(21), and the significance of CCI in patients with non-curative EGAC after ESD remained unclear. Our study demonstrated that age and higher CCI score (≥2) were independent prognostic factors in elderly patients with EGAC treated using ESD, similar to the findings reported in previous studies.…”

Section: Discussionmentioning

confidence: 99%

Effect of Charlson Comorbidity Index and Treatment Strategy on Survival of Elderly Patients After Endoscopic Submucosal Dissection for Gastric Adenocarcinoma: A Multicenter Retrospective Study

Cao

Liu

Wang

et al. 2022

Front. Public Health

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Background: The optimal treatment strategy for elderly patients with early gastric adenocarcinoma (EGAC) after non-curative endoscopic submucosal dissection (ESD) remains unclear. The purpose of this research was to explore the effectiveness of additional treatments after ESD and the factors affecting survival in elderly patients (≥60 years of age) with EGAC.Methods: A total of 639 elderly patients (≥60 years) treated with ESD for EGAC from 2006 to 2018 were retrospectively reviewed. Positive lymphatic infiltration, submucosal infiltration, and positive/indeterminate vertical resection margins are considered high risk factors in histology. According to the risk of lymph node metastasis in patients with EAGC and the treatment strategies adopted after ESD, patients were divided into three groups: there were 484 patients in group A with low risk, 121 patients in group B with high risk, without additional treatment, and 36 patients in group C with high risk, with additional treatment. The 5- and 8-year survival rate, as well as the prognostic factors of survival rate after ESD was studied.Results: The median follow-up time was 38, 40, and 49 months, respectively. There were 3, 4, and 3 deaths related to gastric adenocarcinoma in groups A, B, and C, while deaths from other diseases were 20, 5, and 3, respectively. There were significant differences in overall survival rates between groups (94.3; 86.4; 81.2%, p = 0.110), but there was no significant difference in disease-specific survival rates (98.4; 92.7; 92.4%, p = 0.016). In the multivariate analysis, the Charlson Comorbidity Index (CCI) ≥ 2 was an independent risk factor for death after ESD (hazard ratio 2.39; 95% confidence interval 1.20–4.77; p = 0.014).Conclusions: The strategy of ESD with no subsequent additional treatment for EGAC may be a suitable option for elderly patients at high risk, especially for CCI ≥ 2.

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Impact of the Age-adjusted Charlson comorbidity index on the short- and long-term outcomes of patients undergoing curative gastrectomy for gastric cancer

Cited by 39 publications

References 33 publications

Head and neck melanoma: outcome and predictors in a population-based cohort study

Head and neck melanoma: outcome and predictors in a population-based cohort study

The Clinical Impact of the Age-adjusted Charlson Comorbidity Index on Esophageal Cancer Patients Who Receive Curative Treatment

Effect of Charlson Comorbidity Index and Treatment Strategy on Survival of Elderly Patients After Endoscopic Submucosal Dissection for Gastric Adenocarcinoma: A Multicenter Retrospective Study

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