Comorbidity and survival of Danish patients with colon and rectal cancer from 2000-2011: a population-based cohort study.
Comorbidity and survival of Danish patients with colon and rectal cancer from 2000-2011: a population-based cohort study.
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DOI：
10.2147/clep.s47154
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发表时间：
2013
影响因子：
3.9
通讯作者：
Søgaard M
中科院分区：
文献类型：
--
作者：
Ostenfeld EB;Nørgaard M;Thomsen RW;Iversen LH;Jacobsen JB;Søgaard M
评估丹麦中部地区结直肠癌(CRC)的患病率及其对生存率的影响的最新趋势。使用丹麦国家患者登记处，我们确定了从2000年到2011年分别有5777名和2964名原发性结肠癌或直肠癌患者。我们根据Charlson共病指数评分和使用Cox比例风险回归分析计算的死亡率(MRR)来估计存活率，并根据年龄和性别进行调整。超过三分之一的结直肠癌患者在确诊时有合并症。在研究期间，Charlson评分为0的结肠癌患者的1年存活率大幅增加(72%至80%)，Charlson评分为3以上的患者的1年存活率略有增加(43%至46%)。以Charlson评分为0的结肠癌患者为参照，2000-2002年和2009-2011年，Charlson评分3+患者的调整后1年MRR值分别为2.19(95%可信区间：1.57-3.05)和2.56(95%可信区间：1.96-3.35)。直肠癌后1年生存率在Charlson评分为0的患者中从81%提高到87%，在Charlson评分3+的患者中从56%提高到60%。以Charlson评分0为参照，2000-2002年和2009-2011年的相应MRR分别为2.21(95%CI：1.33~3.68)和3.09(95%CI：1.91~5.00)。五年期的MRR与一年期的MRR没有太大差别。共病在结直肠癌患者中很常见，并且与较差的预后有关。我们观察到，从2000年到2011年，所有合并症水平的患者的存活率都有所提高，但合并疾病的结肠癌患者的存活率改善最小。
To evaluate recent trends in the prevalence and impact of comorbidity on colorectal cancer (CRC) survival in the Central Region of Denmark. Using the Danish National Registry of Patients, we identified 5,777 and 2,964 patients with a primary colon or rectal cancer, respectively, from 2000 through 2011. We estimated survival according to Charlson Comorbidity Index scores and computed mortality rate ratios (MRRs) using Cox proportional hazard regression analysis, adjusting for age and sex. More than one-third of CRC patients had comorbidity at diagnosis. During the study period, 1-year survival increased substantially in colon cancer patients with Charlson score 0 (72% to 80%) and modestly for Charlson score 3+ patients (43% to 46%). Using colon cancer patients with Charlson score 0 as reference, adjusted 1-year MRRs in patients with Charlson score 3+ were 2.19 (95% confidence interval [CI]: 1.57–3.05) in 2000–2002 and 2.56 (95% CI: 1.96–3.35) in 2009–2011. One-year survival after rectal cancer improved from 81% to 87% in patients with Charlson score 0 and from 56% to 60% in Charlson score 3+. Corresponding MRRs in patients with Charlson 3+ were 2.21 (95% CI: 1.33–3.68) in 2000–2002 and 3.09 (95% CI: 1.91–5.00) in 2009–2011 using Charlson score 0 as reference. Five-year MRRs did not differ substantially from 1-year MRRs. Comorbidity was common among CRC patients and was associated with poorer prognosis. We observed improved survival from 2000 to 2011 for all comorbidity levels, with least improvement for colon cancer patients with comorbid conditions.