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Validity of the age-adjusted charlson comorbidity index on clinical outcomes for patients with nasopharyngeal cancer post radiation treatment: a 5-year nationwide cohort study.

Yang CC, Chen PC, Hsu CW, Chang SL, Lee CC - PLoS ONE (2015)

Bottom Line: According to these three different comorbidity index (CCI, ACCI and HN-CCI), higher scores were associated with worse overall survival (P< 0.001).The Receiver Operating Characteristic (ROC) curve was used to assess the discriminating ability of CCI, AACI and HN-CCI scores and it demonstrated the predictive ability for mortality with the ACCI (0.693, 95% CI 0.670-0.715) was superior to that of the CCI (0.619, 95% CI 0.593-0.644) and HN-CCI (0.545, 95%CI 0.519-0.570).Higher comorbidity index scores accurately was associated with worse survival.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Chi-Mei Medical Center, Tainan, Taiwan; Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.

ABSTRACT

Purpose: To characterize the impact of comorbidity on survival outcomes for patients with nasopharyngeal carcinoma (NPC) post radiotherapy (RT).

Methods: A total of 4095 patients with NPC treated by RT or RT plus chemotherapy (CT) in the period from 2007 to 2011 were included through Taiwan's National Health Insurance Research Database. Information on comorbidity present prior to the NPC diagnosis was obtained and adapted to the Charlson Comorbidity Index (CCI), Age-Adjusted Charlson Comorbidity Index (ACCI) and a revised head and neck comorbidity index (HN-CCI). The prevalence of comorbidity and the influence on survival were calculated and analyzed.

Results: Most of the patients (75%) were male (age 51±13 years) and 2470 of them (60%) had at least one comorbid condition. The most common comorbid condition was diabetes mellitus. According to these three different comorbidity index (CCI, ACCI and HN-CCI), higher scores were associated with worse overall survival (P< 0.001). The Receiver Operating Characteristic (ROC) curve was used to assess the discriminating ability of CCI, AACI and HN-CCI scores and it demonstrated the predictive ability for mortality with the ACCI (0.693, 95% CI 0.670-0.715) was superior to that of the CCI (0.619, 95% CI 0.593-0.644) and HN-CCI (0.545, 95%CI 0.519-0.570).

Conclusion: Comorbidities greatly influenced the clinical presentations, therapeutic interventions, and outcomes of patients with NPC post RT. Higher comorbidity index scores accurately was associated with worse survival. The ACCI seems to be a more appropriate prognostic indicator and should be considered in further clinical studies.

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Receiver operating characteristic curve compared the discriminating ability for predicting survival of the ACCI (area = 0.693; 95% CI 0.670 to 0.715), CCI (area = 0.619; 95% CI 0.593 to 0.644) and HN-CCI (area = 0.545; 95% CI 0.519 to 0.570).
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pone.0117323.g003: Receiver operating characteristic curve compared the discriminating ability for predicting survival of the ACCI (area = 0.693; 95% CI 0.670 to 0.715), CCI (area = 0.619; 95% CI 0.593 to 0.644) and HN-CCI (area = 0.545; 95% CI 0.519 to 0.570).

Mentions: The ROC curve was used to assess the discriminating ability of CCI, ACCI and HN-CCI scores. The predictive ability for mortality of ACCI is superior to that of CCI and HN-CCI (Fig. 3). The areas under the ROC curves were 0.693 in ACCI (95% CI 0.670–0.715), 0.619 in CCI (95% CI 0.593–0.644) and 0.545 in HN-CCI (95% CI 0.519–0.570).


Validity of the age-adjusted charlson comorbidity index on clinical outcomes for patients with nasopharyngeal cancer post radiation treatment: a 5-year nationwide cohort study.

Yang CC, Chen PC, Hsu CW, Chang SL, Lee CC - PLoS ONE (2015)

Receiver operating characteristic curve compared the discriminating ability for predicting survival of the ACCI (area = 0.693; 95% CI 0.670 to 0.715), CCI (area = 0.619; 95% CI 0.593 to 0.644) and HN-CCI (area = 0.545; 95% CI 0.519 to 0.570).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4305297&req=5

pone.0117323.g003: Receiver operating characteristic curve compared the discriminating ability for predicting survival of the ACCI (area = 0.693; 95% CI 0.670 to 0.715), CCI (area = 0.619; 95% CI 0.593 to 0.644) and HN-CCI (area = 0.545; 95% CI 0.519 to 0.570).
Mentions: The ROC curve was used to assess the discriminating ability of CCI, ACCI and HN-CCI scores. The predictive ability for mortality of ACCI is superior to that of CCI and HN-CCI (Fig. 3). The areas under the ROC curves were 0.693 in ACCI (95% CI 0.670–0.715), 0.619 in CCI (95% CI 0.593–0.644) and 0.545 in HN-CCI (95% CI 0.519–0.570).

Bottom Line: According to these three different comorbidity index (CCI, ACCI and HN-CCI), higher scores were associated with worse overall survival (P< 0.001).The Receiver Operating Characteristic (ROC) curve was used to assess the discriminating ability of CCI, AACI and HN-CCI scores and it demonstrated the predictive ability for mortality with the ACCI (0.693, 95% CI 0.670-0.715) was superior to that of the CCI (0.619, 95% CI 0.593-0.644) and HN-CCI (0.545, 95%CI 0.519-0.570).Higher comorbidity index scores accurately was associated with worse survival.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Chi-Mei Medical Center, Tainan, Taiwan; Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.

ABSTRACT

Purpose: To characterize the impact of comorbidity on survival outcomes for patients with nasopharyngeal carcinoma (NPC) post radiotherapy (RT).

Methods: A total of 4095 patients with NPC treated by RT or RT plus chemotherapy (CT) in the period from 2007 to 2011 were included through Taiwan's National Health Insurance Research Database. Information on comorbidity present prior to the NPC diagnosis was obtained and adapted to the Charlson Comorbidity Index (CCI), Age-Adjusted Charlson Comorbidity Index (ACCI) and a revised head and neck comorbidity index (HN-CCI). The prevalence of comorbidity and the influence on survival were calculated and analyzed.

Results: Most of the patients (75%) were male (age 51±13 years) and 2470 of them (60%) had at least one comorbid condition. The most common comorbid condition was diabetes mellitus. According to these three different comorbidity index (CCI, ACCI and HN-CCI), higher scores were associated with worse overall survival (P< 0.001). The Receiver Operating Characteristic (ROC) curve was used to assess the discriminating ability of CCI, AACI and HN-CCI scores and it demonstrated the predictive ability for mortality with the ACCI (0.693, 95% CI 0.670-0.715) was superior to that of the CCI (0.619, 95% CI 0.593-0.644) and HN-CCI (0.545, 95%CI 0.519-0.570).

Conclusion: Comorbidities greatly influenced the clinical presentations, therapeutic interventions, and outcomes of patients with NPC post RT. Higher comorbidity index scores accurately was associated with worse survival. The ACCI seems to be a more appropriate prognostic indicator and should be considered in further clinical studies.

Show MeSH
Related in: MedlinePlus