The impact of the Charlson comorbidity index on the prognosis of esophageal cancer patients who underwent esophagectomy with curative intent
The impact of the Charlson comorbidity index on the prognosis of esophageal cancer patients who underwent esophagectomy with curative intent
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DOI：
10.1007/s00595-018-1630-2
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发表时间：
2018-06-01
期刊：
影响因子：
2.5
通讯作者：
Imamura, Yu
中科院分区：
文献类型：
--
作者：
Yamashita, Kotaro;Watanabe, Masayuki;Imamura, Yu
本研究的目的是阐明Charlson合并症指数（CCI）对接受食管切除术的食管癌患者的治疗选择以及短期和中期结局的影响。2009年至2014年接受根治性食管切除术的患者按CCI分类。CCI为2被定义为高，而CCI为0或1被归类为低。比较两组患者的临床病理参数，包括总生存期（OS）和疾病特异性生存期（DSS），在548例患者中，最常见的合并症是慢性阻塞性肺疾病（n = 142，25.9%），其次是实体瘤（n = 79，14.4%）。高CCI与年龄较大（P < 0.001）、单纯手术（P = 0.020）、清扫淋巴结数量较少（P < 0.001）、R0切除率较低（P = 0.048）和住院时间较长（P < 0.001）显著相关。在低剂量组中，术后OS优于高剂量组。尽管两组之间的DSS具有可比性，但CCI与II期疾病患者的不良预后显著相关。CCI与接受根治性食管切除术的食管癌患者的预后显著相关。
The aim of this study was to clarify the influence of Charlson comorbidity index (CCI) on treatment options, and on short- and mid-term outcomes in esophageal cancer patients who underwent esophagectomy.Patients who underwent curative-intent esophagectomy from 2009 to 2014 were classified by CCI. A CCI of 2 was defined as high, while a CCI of 0 or 1 was classified as low. Clinicopathological parameters, including overall survival (OS) and disease-specific survival (DSS), were compared between the groups.Among 548 patients, the most frequent comorbidity was chronic obstructive pulmonary disease (n = 142, 25.9%), followed by solid tumor (n = 79, 14.4%). A high CCI was significantly correlated with older age (P < 0.001), surgery alone (P = 0.020), a lower number of dissected lymph nodes (P < 0.001), lower rate of R0 resection (P = 0.048), and prolonged hospital stay (P < 0.001). In the low group, OS after surgery was favorable in comparison to the the high group. Although DSS was comparable between the groups, the CCI was significantly associated with a poor prognosis in patients with stage II disease.The CCI was significantly correlated with the prognosis of esophageal cancer patients who underwent curative-intent esophagectomy.