TY - JOUR
T1 - Influence of medical comorbidities on the presentation and outcomes of stage I-III non-small-cell lung cancer
AU - Ahn, Daniel H.
AU - Mehta, Nishi
AU - Yorio, Jeffrey T.
AU - Xie, Yang
AU - Yan, Jingsheng
AU - Gerber, David E.
N1 - Funding Information:
Funding was provided by the National Institutes of Health CTSA Grant KL2RR024983 (North and Central Texas Clinical and Translational Science Initiative) (to D.E.G.), the National Cancer Institute Clinical Investigator Team Leadership Award (1P30 CA142543-01 supplement) (to D.E.G.), and an American Cancer Society and Simmons Cancer Center Grant ( ACS-IRG-02-196 ) (to D.E.G.).
PY - 2013/11
Y1 - 2013/11
N2 - Background Non-small-cell lung cancer presentation, treatment, and outcomes vary widely according to socioeconomic factors and other patient characteristics. To determine whether medical comorbidities account for these observations, we incorporated a validated medical comorbidity index into an analysis of patients diagnosed with stage I to III NSCLC. Patients and Methods We performed a retrospective analysis of consecutive patients diagnosed with stage I to III NSCLC. Demographic, tumor, and comorbidity data were obtained from hospital tumor registries and individual patient records. The association between variables was assessed using multivariate logistic regression and survival analysis. Results A total of 454 patients met criteria for analysis. The median age was 65 years, and 51% were men. Individuals with a higher Charlson Comorbidity Index (CCI) were significantly more likely to present with early stage (stage I-II) NSCLC than were patients with lower CCI (odds ratio, 1.72; 95% confidence interval, 1.14-2.63; P =.01), although this association lost statistical significance (P =.21) in a multivariate model. In multivariate logistic regression, overall survival remained associated with all variables: age, sex, race, insurance type, stage, histology, and CCI (P =.0007). The CCI was associated with survival for patients with early stage (P =.02) and locally advanced (P =.02) disease. Conclusion In this cohort of patients with stage I to III NSCLC, increasing comorbidity burden had a nonsignificant association with diagnosis at earlier disease stage. Although comorbidity burden was significantly associated with outcome for early stage and locally advanced disease, it did not account for survival differences based on multiple other patient and disease characteristics.
AB - Background Non-small-cell lung cancer presentation, treatment, and outcomes vary widely according to socioeconomic factors and other patient characteristics. To determine whether medical comorbidities account for these observations, we incorporated a validated medical comorbidity index into an analysis of patients diagnosed with stage I to III NSCLC. Patients and Methods We performed a retrospective analysis of consecutive patients diagnosed with stage I to III NSCLC. Demographic, tumor, and comorbidity data were obtained from hospital tumor registries and individual patient records. The association between variables was assessed using multivariate logistic regression and survival analysis. Results A total of 454 patients met criteria for analysis. The median age was 65 years, and 51% were men. Individuals with a higher Charlson Comorbidity Index (CCI) were significantly more likely to present with early stage (stage I-II) NSCLC than were patients with lower CCI (odds ratio, 1.72; 95% confidence interval, 1.14-2.63; P =.01), although this association lost statistical significance (P =.21) in a multivariate model. In multivariate logistic regression, overall survival remained associated with all variables: age, sex, race, insurance type, stage, histology, and CCI (P =.0007). The CCI was associated with survival for patients with early stage (P =.02) and locally advanced (P =.02) disease. Conclusion In this cohort of patients with stage I to III NSCLC, increasing comorbidity burden had a nonsignificant association with diagnosis at earlier disease stage. Although comorbidity burden was significantly associated with outcome for early stage and locally advanced disease, it did not account for survival differences based on multiple other patient and disease characteristics.
KW - Charlson Index
KW - Disparities
KW - Early stage
KW - Locally advanced
KW - Treatment
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U2 - 10.1016/j.cllc.2013.06.009
DO - 10.1016/j.cllc.2013.06.009
M3 - Article
C2 - 23886797
AN - SCOPUS:84887249927
SN - 1525-7304
VL - 14
SP - 644
EP - 650
JO - Clinical lung cancer
JF - Clinical lung cancer
IS - 6
ER -