The age-adjusted Charlson comorbidity index as a predictor of overall survival of surgically treated non-metastatic clear cell renal cell carcinoma
- Authors
- Kang, Ho Won; Kim, Sung Min; Kim, Won Tae; Yun, Seok Joong; Lee, Sang-Cheol; Kim, Wun-Jae; Hwang, Eu Chang; Kang, Seok Ho; Hong, Sung-Hoo; Chung, Jinsoo; Kwon, Tae Gyun; Kim, Hyeon Hoe; Kwak, Cheol; Byun, Seok-Soo; Kim, Yong-June
- Issue Date
- 1월-2020
- Publisher
- SPRINGER
- Keywords
- Renal cell carcinoma; Nephrectomy; Comorbidity; Prognosis; Survival
- Citation
- JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY, v.146, no.1, pp.187 - 196
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
- Volume
- 146
- Number
- 1
- Start Page
- 187
- End Page
- 196
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/58418
- DOI
- 10.1007/s00432-019-03042-7
- ISSN
- 0171-5216
- Abstract
- Purpose No study has evaluated the prognostic impact of the age-adjusted Charlson comorbidity index (AACI) in those with renal cell carcinoma (RCC). This study aimed to evaluate the utility of the AACI for predicting long-term survival in patients with surgically treated non-metastatic clear cell RCC (ccRCC). Methods Data from 698 patients with non-metastatic ccRCC who underwent radical or partial nephrectomy as primary therapy from a multi-institutional Korean collaboration between 1988 and 2015 were retrospectively analyzed. Clinicopathological variables and survival outcomes of those with AACI scores <= 3 (n = 324), 4-5 (n = 292), and >= 6 (n = 82) were compared. Results Patients with a high AACI score were older and more likely to be female. They were also more likely to have diabetes or hypertension, a worse Eastern Cooperative Oncology Group performance status, and lower preoperative hemoglobin, albumin, serum calcium, and serum total cholesterol levels. Regarding pathologic features, a high AACI score was associated with advanced stage. Kaplan-Meier analyses revealed that AACI >= 6 was associated with shorter cancer-specific (log-rank test, P < 0.001) and overall survival (log-rank test, P < 0.001), but not with recurrence-free survival (log-rank test, P = 0.134). Multivariate Cox regression analyses identified an AACI score as an independent predictor of overall survival (hazard ratio, 6.870; 95% confidence interval, 2.049-23.031; P = 0.002). The AACI score was a better discriminator of overall survival than the Charlson comorbidity index score. Conclusions AACI scores may enable more tailored, individualized management strategies for patients with surgically treated non-metastatic ccRCC.
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