Predictive Capacity of Three Comorbidity Indices in Estimating Mortality After Surgery for Colon Cancer

Robert B Hines; Chakrapani Chatla; Harvey L Bumpers; John W Waterbor; Gerald Mcgwin; Ellen Funkhouser; Christopher S Coffey; James Posey; Upender Manne

doi:10.1200/JCO.2009.22.4758

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Predictive Capacity of Three Comorbidity Indices in Estimating Mortality After Surgery for Colon Cancer

Journal article

Open access

Peer reviewed

Predictive Capacity of Three Comorbidity Indices in Estimating Mortality After Surgery for Colon Cancer

Robert B Hines, Chakrapani Chatla, Harvey L Bumpers, John W Waterbor, Gerald Mcgwin, Ellen Funkhouser, Christopher S Coffey, James Posey and Upender Manne

Journal of clinical oncology, Vol.27(26), pp.4339-4345

2009

DOI: 10.1200/JCO.2009.22.4758

PMCID: PMC2744274

PMID: 19652054

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https://doi.org/10.1200/JCO.2009.22.4758View

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Abstract

Purpose: Although, for patients with cancer, comorbidity can affect the timing of cancer detection, treatment, and prognosis, there is little information relating to the question of whether the choice of comorbidity index affects the results of studies. Therefore, to compare the association of comorbidity with mortality after surgery for colon cancer, this study evaluated the Adult Comorbidity Evaluation-27 (ACE-27), the National Institute on Aging (NIA) and National Cancer Institute (NCI) Comorbidity Index, and the Charlson Comorbidity Index (CCI). Patients and methods: The study population consisted of colon cancer patients (N = 496) who underwent surgery at the University of Alabama at Birmingham Hospital from 1981 to 2002. Hazard ratios (HRs) with 95% CIs were obtained using the method of Cox proportional hazards for the three comorbidity indices in predicting overall and colon cancer-specific mortality. The point estimates obtained for comorbidity and other risk factors across the three models were compared. Results: For each index, the highest comorbidity burden was significantly associated with poorer overall survival (ACE-27: HR = 1.63; 95% CI, 1.24 to 2.15; NIA/NCI: HR = 1.83; 95% CI, 1.29 to 2.61; CCI: HR = 1.46; 95% CI, 1.14 to 1.88) as well as colon cancer-specific survival. For the other risk factors, there was little variation in the point estimates across the three models. Conclusion: The results obtained from these three indices were strikingly similar. For patients with severe comorbidity, all three indices were statistically significant in predicting shorter survival after surgery for colon cancer.

Tumors

Biological and medical sciences

Gastroenterology. Liver. Pancreas. Abdomen

Medical sciences

Stomach. Duodenum. Small intestine. Colon. Rectum. Anus

Details

Title: Subtitle: Predictive Capacity of Three Comorbidity Indices in Estimating Mortality After Surgery for Colon Cancer
Creators: Robert B Hines - University of Alabama at Birmingham
Chakrapani Chatla - University of Alabama at Birmingham
Harvey L Bumpers - University of Alabama at Birmingham
John W Waterbor - University of Alabama at Birmingham
Gerald Mcgwin - University of Alabama at Birmingham
Ellen Funkhouser - University of Alabama at Birmingham
Christopher S Coffey - University of Alabama at Birmingham
James Posey - University of Alabama at Birmingham
Upender Manne - University of Alabama at Birmingham
Resource Type: Journal article
Publication Details: Journal of clinical oncology, Vol.27(26), pp.4339-4345
Publisher: American Society of Clinical Oncology
DOI: 10.1200/JCO.2009.22.4758
PMID: 19652054
PMCID: PMC2744274
ISSN: 0732-183X
eISSN: 1527-7755
Language: English
Date published: 2009
Academic Unit: Biostatistics
Record Identifier: 9984227040102771

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