The Prognostic Value of Eight Comorbidity Indices in Older Patients with Cancer: The ELCAPA Cohort Study

Cancers

on behalf of the ELCAPA Study Group¹  Jean-Leon Lagrange²  Etienne Audureau²  Marc-Antoine Benderra²  Marie Laurent²  Sylvie Bastuji-Garin²  Emilie Ferrat²  Frédégonde About²  Elena Paillaud²  Philippe Caillet²  Lauriane Segaux²  Florence Canoui-Poitrine²  Christophe Tournigand² 

[1] ;IMRB, Institut National de la Santé et de la Recherche Médicale (Inserm), Univ Paris Est Creteil, F-94000 Creteil, France;

关键词: comorbidities;    indices;    mortality;    cancer;    older patients;   

DOI  :  10.3390/cancers14092236

来源: DOAJ

【 摘 要 】

Background: A prognostic assessment is crucial for making cancer treatment decisions in older patients. We assessed the prognostic performance (relative to one-year mortality) of eight comorbidity indices in a cohort of older patients with cancer. Methods: We studied patients with cancer aged ≥70 included in the Elderly Cancer Patient (ELCAPA) cohort between 2007 and 2010. We assessed seven nonspecific indices (Charlson Comorbidity Index (CCI), three modified versions of the CCI, the Elixhauser Comorbidity Index, the Gagne index, and the Cumulative Illness Rating Scale for Geriatrics (CIRS-G)) and the National Cancer Institute Comorbidity Index. Results: Overall, 510 patients were included. Among patients with nonmetastatic cancer, all the comorbidity indices were independently associated with 1-year mortality (adjusted hazard ratios (aHRs) of 1.44 to 2.51 for one standard deviation increment; p < 0.05 for all) and had very good discriminant ability (Harrell’s C > 0.8 for the eight indices), but were poorly calibrated. Among patients with metastatic cancer, only the CIRS-G was independently associated with 1-year mortality (aHR (95% confidence interval): 1.26 [1.06–1.50]). Discriminant ability was moderate (0.61 to 0.70) for the subsets of patients with metastatic cancer and colorectal cancer. Conclusion: Comorbidity indices had strong prognostic value and discriminative ability for one-year mortality in older patients with nonmetastatic cancer, although calibration was poor. In older patients with metastatic cancer, only the CIRS-G was predictive of one-year mortality.

【 授权许可】

Unknown