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- Title
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
- 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.
- Subjects
RENAL cell carcinoma; BLOOD cholesterol; LOG-rank test; COMORBIDITY
- Publication
Journal of Cancer Research & Clinical Oncology, 2020, Vol 146, Issue 1, p187
- ISSN
0171-5216
- Publication type
Article
- DOI
10.1007/s00432-019-03042-7