Is the Charlson Comorbidity Index a Prognostic Indicator for Toxicity and Mortality in Elderly Patients with Locally Advanced Rectal Cancer?

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Kostek Osman; Bozkaya Yakup; Hacioglu Muhammet Bekir; ozdemir Nuriye Yildirim; Yilmaz Erdem; Demircan Nazim Can; Erdogan Bulent; Uzunoglu Sernaz; cicin irfan; Zengin Nurullah

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Journal: ARCHIVES OF IRANIAN MEDICINE Year:2019 | Volume:22 | Issue:5 Page(s): 236-241

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Title

Is the Charlson Comorbidity Index a Prognostic Indicator for Toxicity and Mortality in Elderly Patients with Locally Advanced Rectal Cancer?

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Keywords

Charlson comorbidity index

Elderly patients

Locally advanced rectal cancer

Mortality

Toxicity

Abstract

Background: Aging is significantly related to multiple comorbidities. Even with a good performance score, some Elderly patients may have poor survival outcomes. We aimed to evaluate the prognostic value of the Charlson comorbidity index (CCI) for Mortality and Toxicity in Elderly patients with Locally advanced rectal cancer (LARC). Methods: Seventy-two Elderly patients with LARC who were treated with neoadjuvant chemoradiotherapy (CRT) were included. Based on their CCI score, severity of the comorbidity was categorized into 2 groups: CCI<7 and CCI≥ 7. Results: The overall survival (OS) at 5 years was 54. 4 percent in patients treated with neoadjuvant CRT. Median OS was not reached for all patients as well as patients with CCI score <7, but median OS was 25 (95% CI 1. 0– 62. 1) months in patients with CCI≥ 7 (P = 0. 002). The OS at 2 years was 79. 1 percent in the patients with CCI <7 and 50. 0 percent in the patients with CCI score ≥ 7 (P = 0. 002). Moreover, there was a trend toward, patients with higher CCI score who had more treatment related to grade 3 or 4 Toxicity compared to those with CCI score <7 (33. 3% vs 13. 3%, respectively, P = 0. 09). Multivariable analysis indicated that the CCI score ≥ 7, presence of down-staging after therapy and clinical stage (III) independently predict Mortality (HR 6. 14, 95%CI 2. 45– 15. 35, P < 0. 001) in patients with LARC. Conclusion: Although CCI score was not significantly associated with both Toxicity and disease-free survival (DFS), we suggest that baseline CCI score might be a valuable prognostic indicator for physicians to evaluate elderly patiens with LARC for optimal treatment.

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APA: Copy

Kostek, Osman, Bozkaya, Yakup, Hacioglu, Muhammet Bekir, ozdemir, Nuriye Yildirim, Yilmaz, Erdem, Demircan, Nazim Can, Erdogan, Bulent, Uzunoglu, Sernaz, cicin, irfan, & Zengin, Nurullah. (2019). Is the Charlson Comorbidity Index a Prognostic Indicator for Toxicity and Mortality in Elderly Patients with Locally Advanced Rectal Cancer?. ARCHIVES OF IRANIAN MEDICINE, 22(5), 236-241. SID. https://sid.ir/paper/281783/en

Vancouver: Copy

Kostek Osman, Bozkaya Yakup, Hacioglu Muhammet Bekir, ozdemir Nuriye Yildirim, Yilmaz Erdem, Demircan Nazim Can, Erdogan Bulent, Uzunoglu Sernaz, cicin irfan, Zengin Nurullah. Is the Charlson Comorbidity Index a Prognostic Indicator for Toxicity and Mortality in Elderly Patients with Locally Advanced Rectal Cancer?. ARCHIVES OF IRANIAN MEDICINE[Internet]. 2019;22(5):236-241. Available from: https://sid.ir/paper/281783/en

IEEE: Copy

Osman Kostek, Yakup Bozkaya, Muhammet Bekir Hacioglu, Nuriye Yildirim ozdemir, Erdem Yilmaz, Nazim Can Demircan, Bulent Erdogan, Sernaz Uzunoglu, irfan cicin, and Nurullah Zengin, “Is the Charlson Comorbidity Index a Prognostic Indicator for Toxicity and Mortality in Elderly Patients with Locally Advanced Rectal Cancer?,” ARCHIVES OF IRANIAN MEDICINE, vol. 22, no. 5, pp. 236–241, 2019, [Online]. Available: https://sid.ir/paper/281783/en

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