The age-adjusted Charlson comorbidity index as a predictor of overall survival of surgically treated non-metastatic clear cell renal cell carcinoma

The KORCC (KOrean Renal Cell Carcinoma) group

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)187-196
Number of pages10
JournalJournal of Cancer Research and Clinical Oncology
Volume146
Issue number1
DOIs
StatePublished - 1 Jan 2020

Fingerprint

Renal Cell Carcinoma
Comorbidity
Survival
Nephrectomy
Serum Albumin
Hemoglobins
Cholesterol
Regression Analysis
Confidence Intervals
Hypertension
Calcium
Recurrence
Serum

Keywords

  • Comorbidity
  • Nephrectomy
  • Prognosis
  • Renal cell carcinoma
  • Survival

Cite this

@article{df1d31bf1cdb453e89ff1e2228eb9f8c,
title = "The age-adjusted Charlson comorbidity index as a predictor of overall survival of surgically treated non-metastatic clear cell renal cell carcinoma",
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.",
keywords = "Comorbidity, Nephrectomy, Prognosis, Renal cell carcinoma, Survival",
author = "{The KORCC (KOrean Renal Cell Carcinoma) group} and Kang, {Ho Won} and Kim, {Sung Min} and Kim, {Won Tae} and Yun, {Seok Joong} and Lee, {Sang Cheol} and Kim, {Wun Jae} and Hwang, {Eu Chang} and Kang, {Seok Ho} and Hong, {Sung Hoo} and Jinsoo Chung and Kwon, {Tae Gyun} and Kim, {Hyeon Hoe} and Cheol Kwak and Byun, {Seok Soo} and Kim, {Yong June}",
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The age-adjusted Charlson comorbidity index as a predictor of overall survival of surgically treated non-metastatic clear cell renal cell carcinoma. / The KORCC (KOrean Renal Cell Carcinoma) group.

In: Journal of Cancer Research and Clinical Oncology, Vol. 146, No. 1, 01.01.2020, p. 187-196.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The age-adjusted Charlson comorbidity index as a predictor of overall survival of surgically treated non-metastatic clear cell renal cell carcinoma

AU - The KORCC (KOrean Renal Cell Carcinoma) group

AU - Kang, Ho Won

AU - Kim, Sung Min

AU - Kim, Won Tae

AU - Yun, Seok Joong

AU - Lee, Sang Cheol

AU - Kim, Wun Jae

AU - Hwang, Eu Chang

AU - Kang, Seok Ho

AU - Hong, Sung Hoo

AU - Chung, Jinsoo

AU - Kwon, Tae Gyun

AU - Kim, Hyeon Hoe

AU - Kwak, Cheol

AU - Byun, Seok Soo

AU - Kim, Yong June

PY - 2020/1/1

Y1 - 2020/1/1

N2 - 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.

AB - 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.

KW - Comorbidity

KW - Nephrectomy

KW - Prognosis

KW - Renal cell carcinoma

KW - Survival

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U2 - 10.1007/s00432-019-03042-7

DO - 10.1007/s00432-019-03042-7

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JO - Journal of cancer research and clinical oncology

JF - Journal of cancer research and clinical oncology

SN - 0171-5216

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