Prognostic impact of increasing age and co-morbidity in cancer patients: A population-based approach

Janssen‐Heijnen, M.L.G.; Houterman, Saskia; Lemmens, Valery; Louwman, Marieke W. J.; Maas, Huub; Coebergh, Jan Willem

doi:10.1016/j.critrevonc.2005.04.008

Cited by 328 publications

(238 citation statements)

References 37 publications

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“…The most common complication was cardiovascular disease. Mortality among those of over 70 years was much higher than that of among younger patients after the surgery of non-small cell lung cancer (11% vs. 2%, P<0.01); and cardiovascular and thrombotic events were also more common in older lung cancer patients [10] In our study, tumor size was found to be a major factor associated with mortality risk. This is consistent with the findings in the literature.…”

Section: Discussionmentioning

confidence: 68%

Prognostic factors for survival of stage IB upper lobe non-small cell lung cancer patients: A retrospective study in Shanghai, China

Wang

Yang

Wang

2011

Chin. J. Cancer Res.

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Objective: To identify clinical and pathologic factors that were associated with the survival of stage IB upper lobe non-small cell lung cancer (NSCLC) patients.Methods: A retrospective study of 147 subjects who had undergone curative resection for stage IB upper lobe NSCLC was performed. Patients who had received any adjuvant or neo-adjuvant chemotherapy were excluded. Survival function curves were estimated using the Kaplan-Meier procedure. Crude and adjusted hazard ratios (HRs) of potential prognostic factors were estimated using Cox proportional hazards models.Results: Five factors, including age, tumor size, histologic grade of differentiation, number of removed superior mediastinal lymph node stations and presence of visceral pleura invasion, were significantly and independently associated with mortality risk. Adjusted HRs were 2.6 [95% confidence interval (95% CI): 1.1−6.5] and 4.6 (95% CI: 1.9−11) for those aged 58−68 years and those >68 years, respectively, relative to those aged <58 years. HRs for those with poorly and moderately differentiated tumors were 6.4 (95% CI: 2.3−18) and 1.4 (95% CI: 0.7−2.8), respectively. HRs for those with tumor size 3.1−5 cm and >5 cm (vs ≤3.0 cm) were 2.3 (95% CI: 1.1−4.9) and 4.3 (95% CI: 1.9−10), respectively. The presence of visceral pleura invasion also increased the risk of mortality (HR=4.0, 95% CI: 1.3−12).Conclusion: Advanced age, larger tumor size, poorly differentiated histology, smaller number of removed superior mediastinal lymph node stations, and presence of visceral pleura invasion were associated with poor survival of surgically treated stage IB upper lobe NSCLC patients.

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Section: Discussionmentioning

confidence: 68%

Prognostic factors for survival of stage IB upper lobe non-small cell lung cancer patients: A retrospective study in Shanghai, China

Wang

Yang

Wang

2011

Chin. J. Cancer Res.

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“…14,[31][32][33] Simultaneously, surgery is often performed regardless of age and comorbidity if only to avoid the consequences of tumor obstruction. 8 Estimating the risk of (postoperative) adverse outcomes is important in establishing informed patient consent and shared decision-making 34,35 on the extent of intended surgery and appliance of adjuvant therapy. However, the development of personalized care programs is bothered by limited knowledge about the relation of comorbidity and cancer biology and what (combination of) chronic diseases are prone for complications and death.…”

Section: Discussionmentioning

confidence: 99%

“…6 The presence of a single or combination of chronic illnesses can affect both treatment effectiveness and tolerance, and is associated with worse short-and long-term outcomes after CRC surgery. [1][2][3][4][7][8][9][10][11] The prevalence of comorbidity is influenced by personal and environmental factors. Age, gender and socio-economic status (SES) have been described as interacting with the burden of specific comorbid ailments and influencing outcomes after CRC treatment.…”

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confidence: 99%

Increasing prevalence of comorbidity in patients with colorectal cancer in the South of the Netherlands 1995–2010

Leersum

Janssen‐Heijnen

Wouters

et al. 2012

Intl Journal of Cancer

103

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Comorbidity has large impact on colorectal cancer (CRC) treatment and outcomes and may increase as the population ages. We aimed to evaluate the prevalence and time trends of comorbid diseases in patients with CRC from 1995 to 2010. The Eindhoven Cancer Registry registers comorbidity in all patients with primary CRC in the South of the Netherlands. We analyzed the prevalence of serious comorbid diseases in four time frames from 1995 to 2010. Thereby, we addressed its association with age, gender and socio-economic status (SES). The prevalence of comorbidity was registered in 27,339 patients with primary CRC. During the study period, the prevalence of comorbidity increased from 47% to 62%, multimorbidity increased from 20% to 37%. Hypertension and cardiovascular diseases were most prevalent and increased largely over time (respectively 16-29% and 12-24%). Pulmonary diseases increased in women, but remained stable in men. Average age at diagnosis increased from 68.3 to 69.5 years (p 5 0.004). A low SES and male gender were associated with a higher risk of comorbidity (not changing over time). This study indicates that comorbidity among patients with CRC is common, especially in males and patients with a low SES. The prevalence of comorbidity increased from 1995 to 2010, in particular in presumably nutritional diseases. Ageing, increased life expectancy and life style changes may contribute to more comorbid diseases. Also, improved awareness among health care providers on the importance of comorbidity may have resulted in better registration. The increasing burden of comorbidity in patients with CRC emphasizes the need for more focus on individualized medicine.Comorbidity composes a great challenge when treating patients with colorectal cancer (CRC). [1][2][3][4] In the Netherlands, CRC represents the second most frequent cancer in terms of incidence with more than 12,000 newly diagnosed patients annually and a lifetime risk of more than 5%. 5 As more than half of patients with CRC is aged older than 70 years, the diagnosis of CRC is often made amidst the presence of other chronic medical conditions. Treatment of patients with severe comorbidity is challenging because of polypharmacy and decreased compensating mechanisms, especially in older patients who also have normal age-related physiological changes. 6 The presence of a single or combination of chronic illnesses can affect both treatment effectiveness and tolerance, and is associated with worse short-and long-term outcomes after CRC surgery. [1][2][3][4][7][8][9][10][11] The prevalence of comorbidity is influenced by personal and environmental factors. Age, gender and socio-economic status (SES) have been described as interacting with the burden of specific comorbid ailments and influencing outcomes after CRC treatment. [12][13][14] Further, ageing, improved life expectancy and lifestyle habits in western countries will lead to a higher prevalence of (multiple) concomitant diseases among patients with CRC. 15,16 Objectifying increases in the burden of comorbi...

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“…In an ageing population the prevalence of coexisting medical diseases in addition to cancer becomes increasingly important [55,56]. Depression is common not only among cancer patients but also in other medical illnesses such as diabetes and cardiovascular diseases [57,58], these being the most common coexisting illnesses in cancer patients [59].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and risk of depressive symptoms 3–4 months post-surgery in a nationwide cohort study of Danish women treated for early stage breast-cancer

Christensen

Zachariae

Jensen

et al. 2008

Breast Cancer Res Treat

132

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Prognostic impact of increasing age and co-morbidity in cancer patients: A population-based approach

Cited by 328 publications

References 37 publications

Prognostic factors for survival of stage IB upper lobe non-small cell lung cancer patients: A retrospective study in Shanghai, China

Prognostic factors for survival of stage IB upper lobe non-small cell lung cancer patients: A retrospective study in Shanghai, China

Increasing prevalence of comorbidity in patients with colorectal cancer in the South of the Netherlands 1995–2010

Prevalence and risk of depressive symptoms 3–4 months post-surgery in a nationwide cohort study of Danish women treated for early stage breast-cancer

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