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Evaluation of the effect of comorbidity on survival in pancreatic cancer by using “Charlson Comorbidity Index” and “Cumulative Illness Rating Scale”

Bewertung der Auswirkung von Begleiterkrankungen auf das Überleben mit Pankreaskrebs unter Verwendung des „Charlson Komorbiditäts Index“ und der „Cumulative Illness Rating Skala“

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Summary

Background

Effect of comorbidity on the treatments that patients receive is not clear, as healthy elderly patients and the elderly with less comorbid diseases are included in the studies. In the present study, the effect of comorbidity on the survival was evaluated using Charlson Comorbidity Index (CCI) and Cumulative Illness Rating Scale (CIRS).

Material and method

The general features and comorbid diseases of the pancreatic cancer patients were retrospectively screened from the patient files using the automated system. CCI and CIRS were used as the comorbidity indices.

Results

A total of 106 patients with pancreatic cancer were included in the study. The median overall survival rate was 9.0 [95 % confidence interval (CI): 6.7–11.3] months. The median overall survival rate was found as 9.4 (95 % CI: 6.7–12.1) months in the patients whose CCI score was ≤ 2 and was found as 6.2 (95 % CI: 4.0–8.3) months in the patients with CCI scores ≥ 3 (p = 0.05). The median overall survival rate was calculated as 9.8 (95 % CI: 6.3–13.4) months in the patients with CIRS scores ≤ 2 and was calculated as 8.3 (95 % CI: 6.0–10.6) months in the patients with CIRS scores ≥ 3 (p = 0.51). When surgery, radiotherapy, grading, and CCI score were evaluated using multivariate analysis, it was observed that only the treatment modality had a significant effect on the survival rate.

Conclusion

The results on the use of comorbidity indices are contradictory for the cancers with lower survival rates such as pancreatic cancer. New prognostic scales might be developed for this patient group by considering the side effects of chemotherapy.

Zusammenfassung

Grundlagen

Die Auswirkung von Begleiterkrankungen auf den Erfolg der Therapien, die Patienten erhalten, ist ungesichert, da oft gesunde ältere Patienten beziehungsweise Ältere mit nur wenigen Begleiterkrankungen in die Studien eingeschlossen werden. In der vorliegenden Studie wurde der Einfluss von Begleiterkrankungen auf das Überleben durch Verwendung des Charlson Komorbiditäts Index (CKI) und der Kumulativen Erkrankungs-Bewertung Skala (KEBS) bewertet.

Material und Methoden

Die Allgemeinsituation und Begleiterkrankungen von Patienten mit Pankreaskrebs wurden retrospektiv an Hand der Krankengeschichten mit Hilfe eines automatisierten Systems erhoben. CKI und KEBS wurden als Indices verwendet.

Ergebnisse

Insgesamt wurden 106 Patienten mit Pankreaskrebs in die Studie aufgenommen. Die mediane Gesamt-Überlebenszeit betrug 9 Monate (95 % CI; 6,7–11,3). Bei den Patienten mit einen CKI < 2 lag die Gesamtüberlebenszeit bei 9,4 Monaten (95 % CI; 6,7–12,1); bei den Patienten mit einem CKI ≥ 3 lag sie bei 6,2 Monaten (95 % CI; 4,0–8,3). Bei der Einteilung nach KEBS ergab sich eine Gesamtüberlebenszeit von 9,8 Monaten (6,3–13,4) bei jenen ≤ 2 und von 8,3 (95 % CI: 6,0–10,6) bei einem KEBS Wert von ≥ 3 (p = 0,51). Die Berücksichtigung der Operation, der Bestrahlung, des Stadiums und des CKI Scores in der Multivarianz Analyse ergab, dass nur die Therapiemodalität einen signifikanten Einfluss auf die Überlebensrate hatte.

Schlussfolgerung

Die Ergebnisse des Einsatzes von Komorbiditätsindices sind bei Krebserkrankungen mit geringer Lebenserwartung, wie dem Pankreaskrebs, widersprüchlich. Neue prognostische Skalen sollten für diese Patienten unter Berücksichtigung der Nebenwirkungen der Chemotherapie erstellt werden.

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Authors and Affiliations

  1. Department of Medical Oncology, Kahramanmaras Sutcu Imam University Faculty of Medicine, 46000, Merkez, Kahramanmaras, Turkey

    F. Tugba Kos

  2. Department of Medical Oncology, Ankara Numune Education and Research Hospital, Ankara, Turkey

    Ozan Yazici, Burak Civelek, Dogan Uncu, Nuriye Ozdemir & Nurullah Zengin

  3. Department of Medical Oncology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey

    Metin Seker

  4. Department of Medical Oncology, Hacettepe University Institute of Oncology, Ankara, Turkey

    Zafer Arik & Sercan Aksoy

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  1. F. Tugba Kos
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Correspondence to F. Tugba Kos.

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Kos, F., Yazici, O., Civelek, B. et al. Evaluation of the effect of comorbidity on survival in pancreatic cancer by using “Charlson Comorbidity Index” and “Cumulative Illness Rating Scale”. Wien Klin Wochenschr 126, 36–41 (2014). https://doi.org/10.1007/s00508-013-0453-9

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  • DOI: https://doi.org/10.1007/s00508-013-0453-9

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