期刊
CLINICAL LUNG CANCER
卷 14, 期 6, 页码 644-650出版社
CIG MEDIA GROUP, LP
DOI: 10.1016/j.cllc.2013.06.009
关键词
Charlson Index; Disparities; Early stage; Locally advanced; Treatment
类别
资金
- National Cancer Institute Cancer Center Support Grant [1P30 CA142543-01]
- National Institutes of Health CTSA Grant (North and Central Texas Clinical and Translational Science Initiative) [KL2RR024983]
- National Cancer Institute Clinical Investigator Team Leadership Award [1P30 CA142543-01]
- American Cancer Society
- Simmons Cancer Center Grant [ACS-IRG-02196]
Disparities in none-small-cell lung cancer (NSCLC) presentation, treatment, and outcomes are affected by many factors and patient characteristics. To determine whether medical comorbidities account for these findings, we used a validated medical comorbidity index in an analysis of patients with stage I to III NSCLC. Our findings showed that patients with a higher degree of medical comorbidities might be more likely to present with early stage disease. Despite this association, a higher degree of comorbidity burden predicted worse clinical outcomes. Background: Nonesmall-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.
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