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Comorbidities and its relation to performance status and estimated survival rate among cancer patients

Yıl 2019, Cilt: 23 Sayı: 2, 304 - 314, 27.06.2025

Sankar Veintramuthu Rama Parthasarathy Sangeetha Mathew Subash John Vignesh Kanda Kumar Prudence Attilade Rodrigues

Öz

Many studies report the presence of comorbidities, which have a consequential impact on the management and survival of cancer patients. The aim of the present study is to assess the prevalence of comorbidities and their influence on overall management, estimated survival, and performance of cancer patients. A hospital based prospective study was conducted at a multi-specialty teaching hospital for a period of 10 months. Out of a sample of 140 cancer patients, 70 were diagnosed with comorbidities. Estimated survival rates and comorbidity scores were assessed using the Charlson Comorbidity Index (CCI). Performance scores were observed using the Eastern Cooperative Oncology Group (ECOG) performance score. CCI and performance score were statistically analyzed by SPSS Version 19. Hypertension (40%) was the leading comorbidity, followed by diabetes (25.71%). Those women with high (>5) CCI score (57.14%, p=0.04) had significantly decreased estimated survival rates of less than or equal to 2 months compared to those having less than (<) 2 CCI score and who reached estimated survival rates of more than or equal to 7 months. The performance score (2.065±0.81) was significantly (P=0.0001) increased after treatment of the comorbidity compared to the performance score (1.125±1.27) of patients without comorbidity. Only alkylating agents (cyclophosphamide p=0.003, Carboplatin & Oxaliplatin p= 0.007, Cisplatin p= 0.0001), and folic acid analogues (Leucovorin p=0.01) showed significant differences in the management of cancer between groups. This study suggests that breast cancer is associated with increased comorbidity burden compared to other types of cancer. Also, comorbidity is associated with overall decreased estimated survival rate and performance status among cancer patients.

Anahtar Kelimeler

Cancer comorbidity estimated survival rate treatment pattern performance status CCI ECOG

Kaynakça

  • [1] Varghese C. 50 years of cancer control in India. In: Varghese C. (Eds). Cancer Prevention and Control in India, Government of India, New Delhi: MHFW 2002, pp. 48-59.
  • [2] Hall SF, Rochon PA, Paszat LF, Groome PA, Rohland SL. Measuring comorbidity in patients with head and neck cancer. Laryngoscope. 2002; 112(1):1988-1996. [CrossRef]
  • [3] Søgaard M, Thomsen RW, Bossen KS, Sørensen HT, Nørgaard M. The impact of comorbidity on cancer survival: a review. Clin Epidemiol. 2013; 5(1):3–29. [CrossRef]
  • [4] Fouad MN, Mayo CP, Funkhouser EM, Irene Hall H, Urban DA, Kiefe CI. Comorbidity independently predicted death in older prostate cancer patients, more of whom died with than from their disease. J Clin Epidemiol. 2004; 57(7):721-729. [CrossRef]
  • [5] Geraci JM, Escalante CP, Freeman JL, Goodwin JS. Comorbid disease and cancer: the need for more relevant conceptual models in health services research. J Clin Oncol. 2005; 23(30):7399-7404. [CrossRef]
  • [6] Mallath MK, Taylor DG, Badwe RA, Rath GK, Shanta V, Pramesh CS, et al. The growing burden of cancer in India: epidemiology and social context. Lancet Oncol. 2014; 15(6):205-212. [CrossRef]
  • [7] Gopalakrishnan S, Umadevi R. An epidemiological analysis of cancer patients admitted to hospitals in Chennai, Tamil Nadu. Int J Community Med Public Health. 2015; 2(1):3-9. [CrossRef]
  • [8] Ershler WB, Longo DL. Aging and Cancer: Issues of Basic and Clinical Science. J Natl Cancer Inst. 1997; 89(20):1489–1497.
  • [9] Land LH, Dalton SO, Jensen MB, Ewertz M. Influence of comorbidity on the effect of adjuvant treatment and age in patients with early-stage breast cancer. Br J Cancer. 2012; 107(11):1901–1907. [CrossRef]
  • [10] Ording G, Cronin-Fenton DP, Jacobsen JB, Nørgaard M, Thomsen RW, Christiansen P. Comorbidity and survival of Danish breast cancer patients from 2000-2011: a population-based cohort study. Clin Epidemiol. 2013; 5:39-46. [CrossRef]
  • [11] Sarfati D, Gurney J, Stanley J, Koea J. A retrospective cohort study of patients with stomach and liver cancers: the impact of comorbidity and ethnicity on cancer care and outcomes. BMC Cancer. 2014; 14:821. [CrossRef]
  • [12] Deleuran T, Thomsen RW, Nørgaard M, Jacobsen JB, Rasmussen TR. Comorbidity and survival of Danish lung cancer patients from 2000-2011: a population-based cohort study. Clin Epidemiol. 2013; 5:31-38. [CrossRef]
  • [13] Ostenfeld EB, Nørgaard M, Thomsen RW, Iversen LH, Jacobsen JB, Søgaard M. Comorbidity and survival of Danish patients with colon and rectal cancer from 2000-2011: a population-based cohort study. Clin Epidemiol. 2013; 5(1):65-74. [CrossRef]
  • [14] Erichsen R, Horváth-Puh E, Iversen LH, Lash TL, Sørensen HT. Does comorbidity interact with colorectal cancer to increase mortality? A nationwide population-based cohort study. Br J Cancer. 2013; 109(7):2005-2013. [CrossRef]
  • [15] Shinn EH, Lenihan DJ, Urbauer DL, Engquist KM, Valentine A, Palmero L, et al. Impact of cardiovascular comorbidity on ovarian cancer mortality. Cancer Epidemiol Biomarkers Prev. 2013; 22(11):2102-2109. [CrossRef]
  • [16] Ranc K, Jørgensen ME, Friis S, Carstensen B. Mortality after cancer among patients with diabetes mellitus: effect of diabetes duration and treatment. Diabetologia. 2014; 57(5):927-934. [CrossRef]
  • [17] Shieh SH, Probst JC, Sung FC, Tsai WC, Li YS, Chen CY. Decreased survival among lung cancer patients with comorbid tuberculosis and diabetes. BMC Cancer. 2012; 12:174. [CrossRef]
  • [18] Li J, Cao G, Ma Q, Liu H, Li W, Han L. The bi-directional interaction between pancreatic cancer and diabetes. World J Surg Oncol. 2012; 10:171. [CrossRef]
  • [19] Bellury L, Pett MA, Ellington L, Beck SL, Clark JC, Stein KD. The effect of aging and cancer on the symptom experience and physical function of elderly breast cancer survivors. Cancer. 2012; 118(24):6171-6178. [CrossRef]
  • [20] Demirpence M, Akman T, Oztop I, Unek IT, Yavuzsen T, Yilmaz AU. Impact of accompanying comorbidities on survival in patients with stage IIIB-IV non-small-cell lung cancer. Int J Hematol Oncol. 2014; 24(4):223–232. [CrossRef]
  • [21] Ozkaya S, Findik S, Dirican A, Atici AG. Long-term survival rates of patients with stage IIIB and IV non-small cell lung cancer treated with cisplatin plus vinorelbine or gemcitabine. Exp Ther Med. 2012; 4(6):1035–1038. [CrossRef]
  • [22] Mohammadi M, Cao Y, Glimelius I, Bottai M, Eloranta S, Smedby KE. The impact of comorbid disease history on all-cause and cancer-specific mortality in myeloid leukemia and myeloma – a Swedish population-based study. BMC Cancer. 2015; 15:850. [CrossRef]
  • [23] Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40(5):373-383.
  • [24] Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET. Toxicity and response criteria of the eastern cooperative oncology group. Am J Clin Oncol. 1982; 5(6):649-655.

Yıl 2019, Cilt: 23 Sayı: 2, 304 - 314, 27.06.2025

Sankar Veintramuthu Rama Parthasarathy Sangeetha Mathew Subash John Vignesh Kanda Kumar Prudence Attilade Rodrigues

Öz

Kaynakça

  • [1] Varghese C. 50 years of cancer control in India. In: Varghese C. (Eds). Cancer Prevention and Control in India, Government of India, New Delhi: MHFW 2002, pp. 48-59.
  • [2] Hall SF, Rochon PA, Paszat LF, Groome PA, Rohland SL. Measuring comorbidity in patients with head and neck cancer. Laryngoscope. 2002; 112(1):1988-1996. [CrossRef]
  • [3] Søgaard M, Thomsen RW, Bossen KS, Sørensen HT, Nørgaard M. The impact of comorbidity on cancer survival: a review. Clin Epidemiol. 2013; 5(1):3–29. [CrossRef]
  • [4] Fouad MN, Mayo CP, Funkhouser EM, Irene Hall H, Urban DA, Kiefe CI. Comorbidity independently predicted death in older prostate cancer patients, more of whom died with than from their disease. J Clin Epidemiol. 2004; 57(7):721-729. [CrossRef]
  • [5] Geraci JM, Escalante CP, Freeman JL, Goodwin JS. Comorbid disease and cancer: the need for more relevant conceptual models in health services research. J Clin Oncol. 2005; 23(30):7399-7404. [CrossRef]
  • [6] Mallath MK, Taylor DG, Badwe RA, Rath GK, Shanta V, Pramesh CS, et al. The growing burden of cancer in India: epidemiology and social context. Lancet Oncol. 2014; 15(6):205-212. [CrossRef]
  • [7] Gopalakrishnan S, Umadevi R. An epidemiological analysis of cancer patients admitted to hospitals in Chennai, Tamil Nadu. Int J Community Med Public Health. 2015; 2(1):3-9. [CrossRef]
  • [8] Ershler WB, Longo DL. Aging and Cancer: Issues of Basic and Clinical Science. J Natl Cancer Inst. 1997; 89(20):1489–1497.
  • [9] Land LH, Dalton SO, Jensen MB, Ewertz M. Influence of comorbidity on the effect of adjuvant treatment and age in patients with early-stage breast cancer. Br J Cancer. 2012; 107(11):1901–1907. [CrossRef]
  • [10] Ording G, Cronin-Fenton DP, Jacobsen JB, Nørgaard M, Thomsen RW, Christiansen P. Comorbidity and survival of Danish breast cancer patients from 2000-2011: a population-based cohort study. Clin Epidemiol. 2013; 5:39-46. [CrossRef]
  • [11] Sarfati D, Gurney J, Stanley J, Koea J. A retrospective cohort study of patients with stomach and liver cancers: the impact of comorbidity and ethnicity on cancer care and outcomes. BMC Cancer. 2014; 14:821. [CrossRef]
  • [12] Deleuran T, Thomsen RW, Nørgaard M, Jacobsen JB, Rasmussen TR. Comorbidity and survival of Danish lung cancer patients from 2000-2011: a population-based cohort study. Clin Epidemiol. 2013; 5:31-38. [CrossRef]
  • [13] Ostenfeld EB, Nørgaard M, Thomsen RW, Iversen LH, Jacobsen JB, Søgaard M. Comorbidity and survival of Danish patients with colon and rectal cancer from 2000-2011: a population-based cohort study. Clin Epidemiol. 2013; 5(1):65-74. [CrossRef]
  • [14] Erichsen R, Horváth-Puh E, Iversen LH, Lash TL, Sørensen HT. Does comorbidity interact with colorectal cancer to increase mortality? A nationwide population-based cohort study. Br J Cancer. 2013; 109(7):2005-2013. [CrossRef]
  • [15] Shinn EH, Lenihan DJ, Urbauer DL, Engquist KM, Valentine A, Palmero L, et al. Impact of cardiovascular comorbidity on ovarian cancer mortality. Cancer Epidemiol Biomarkers Prev. 2013; 22(11):2102-2109. [CrossRef]
  • [16] Ranc K, Jørgensen ME, Friis S, Carstensen B. Mortality after cancer among patients with diabetes mellitus: effect of diabetes duration and treatment. Diabetologia. 2014; 57(5):927-934. [CrossRef]
  • [17] Shieh SH, Probst JC, Sung FC, Tsai WC, Li YS, Chen CY. Decreased survival among lung cancer patients with comorbid tuberculosis and diabetes. BMC Cancer. 2012; 12:174. [CrossRef]
  • [18] Li J, Cao G, Ma Q, Liu H, Li W, Han L. The bi-directional interaction between pancreatic cancer and diabetes. World J Surg Oncol. 2012; 10:171. [CrossRef]
  • [19] Bellury L, Pett MA, Ellington L, Beck SL, Clark JC, Stein KD. The effect of aging and cancer on the symptom experience and physical function of elderly breast cancer survivors. Cancer. 2012; 118(24):6171-6178. [CrossRef]
  • [20] Demirpence M, Akman T, Oztop I, Unek IT, Yavuzsen T, Yilmaz AU. Impact of accompanying comorbidities on survival in patients with stage IIIB-IV non-small-cell lung cancer. Int J Hematol Oncol. 2014; 24(4):223–232. [CrossRef]
  • [21] Ozkaya S, Findik S, Dirican A, Atici AG. Long-term survival rates of patients with stage IIIB and IV non-small cell lung cancer treated with cisplatin plus vinorelbine or gemcitabine. Exp Ther Med. 2012; 4(6):1035–1038. [CrossRef]
  • [22] Mohammadi M, Cao Y, Glimelius I, Bottai M, Eloranta S, Smedby KE. The impact of comorbid disease history on all-cause and cancer-specific mortality in myeloid leukemia and myeloma – a Swedish population-based study. BMC Cancer. 2015; 15:850. [CrossRef]
  • [23] Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40(5):373-383.
  • [24] Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET. Toxicity and response criteria of the eastern cooperative oncology group. Am J Clin Oncol. 1982; 5(6):649-655.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Eczacılık Bilimleri, Klinik Farmakoloji ve Terapötikler, Temel Farmakoloji
Bölüm Articles
Yazarlar

Sankar Veintramuthu

Rama Parthasarathy

Sangeetha Mathew

Subash John

Vignesh Kanda Kumar

Prudence Attilade Rodrigues

Yayımlanma Tarihi 27 Haziran 2025
Yayımlandığı Sayı Yıl 2019 Cilt: 23 Sayı: 2

Kaynak Göster

APA Veintramuthu, S., Parthasarathy, R., Mathew, S., John, S., vd. (2025). Comorbidities and its relation to performance status and estimated survival rate among cancer patients. Journal of Research in Pharmacy, 23(2), 304-314.
AMA Veintramuthu S, Parthasarathy R, Mathew S, John S, Kanda Kumar V, Attilade Rodrigues P. Comorbidities and its relation to performance status and estimated survival rate among cancer patients. J. Res. Pharm. Haziran 2025;23(2):304-314.
Chicago Veintramuthu, Sankar, Rama Parthasarathy, Sangeetha Mathew, Subash John, Vignesh Kanda Kumar, ve Prudence Attilade Rodrigues. “Comorbidities and Its Relation to Performance Status and Estimated Survival Rate Among Cancer Patients”. Journal of Research in Pharmacy 23, sy. 2 (Haziran 2025): 304-14.
EndNote Veintramuthu S, Parthasarathy R, Mathew S, John S, Kanda Kumar V, Attilade Rodrigues P (01 Haziran 2025) Comorbidities and its relation to performance status and estimated survival rate among cancer patients. Journal of Research in Pharmacy 23 2 304–314.
IEEE S. Veintramuthu, R. Parthasarathy, S. Mathew, S. John, V. Kanda Kumar, ve P. Attilade Rodrigues, “Comorbidities and its relation to performance status and estimated survival rate among cancer patients”, J. Res. Pharm., c. 23, sy. 2, ss. 304–314, 2025.
ISNAD Veintramuthu, Sankar vd. “Comorbidities and Its Relation to Performance Status and Estimated Survival Rate Among Cancer Patients”. Journal of Research in Pharmacy 23/2 (Haziran 2025), 304-314.
JAMA Veintramuthu S, Parthasarathy R, Mathew S, John S, Kanda Kumar V, Attilade Rodrigues P. Comorbidities and its relation to performance status and estimated survival rate among cancer patients. J. Res. Pharm. 2025;23:304–314.
MLA Veintramuthu, Sankar vd. “Comorbidities and Its Relation to Performance Status and Estimated Survival Rate Among Cancer Patients”. Journal of Research in Pharmacy, c. 23, sy. 2, 2025, ss. 304-1.
Vancouver Veintramuthu S, Parthasarathy R, Mathew S, John S, Kanda Kumar V, Attilade Rodrigues P. Comorbidities and its relation to performance status and estimated survival rate among cancer patients. J. Res. Pharm. 2025;23(2):304-1.