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Erschienen in: Journal of Cancer Research and Clinical Oncology 11/2004

01.11.2004 | Original Paper

The impact of comorbidity on the survival of postmenopausal women with breast cancer

verfasst von: G. Nagel, U. Wedding, H. Hoyer, B. Röhrig, D. Katenkamp

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 11/2004

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Abstract

Purpose

The aim was to assess the impact of comorbidity on survival of postmenopausal women with breast cancer diagnosis in the period 1995–1997.

Methods

The level of comorbidity was described by the methods suggested by Satariano and Charlson. Cox’s proportional hazard models were used to explore the impact of comorbidity on all-cause mortality.

Results

After a median follow-up time of 52 months, an increasing level of comorbidity was associated with a higher all-cause mortality. Compared to patients without comorbid conditions, the hazard ratio of death (HR) was 1.2 (95% CI: 0.8–1.7) for Satariano index 1 and HR 2.3 (95% CI: 1.5–3.5) for Satariano index ≥2, and HR 1.6 and 2.1 for the Charlson comorbidity index, respectively. Independent of comorbidity, the treatment pattern had a strong impact on survival. The level of comorbidity has an influence on the 3-year survival of postmenopausal women with breast cancer.

Conclusions

Long-term follow-up is required to appraise these findings in relation to treatment strategies.
Literatur
1.
Zurück zum Zitat International Agency for Research on Cancer Globocan 2000 (2001) Cancer incidence, mortality and prevalence wordwide. IARC, Lyon, 2001 International Agency for Research on Cancer Globocan 2000 (2001) Cancer incidence, mortality and prevalence wordwide. IARC, Lyon, 2001
2.
Zurück zum Zitat Van den Akker M, Buntinx F, Matsemakers JF, et al (1988) Multimorbidity in general practice: prevalence, incidence and determinants of co-occurring chronic and recurrent diseases. J Clin Epidemiol 51:367–375 Van den Akker M, Buntinx F, Matsemakers JF, et al (1988) Multimorbidity in general practice: prevalence, incidence and determinants of co-occurring chronic and recurrent diseases. J Clin Epidemiol 51:367–375
3.
Zurück zum Zitat Yancik R, Wesley MN, Ries LA, et al (2001) Effect of age and comorbidity in postmenopausal breast cancer patients aged 55 years and older. JAMA 285:885–892CrossRefPubMed Yancik R, Wesley MN, Ries LA, et al (2001) Effect of age and comorbidity in postmenopausal breast cancer patients aged 55 years and older. JAMA 285:885–892CrossRefPubMed
4.
Zurück zum Zitat Feinstein AR (1970) The pre-therapeutic classification of co-morbidity in chronic disease. J Chron Dis 23:455–469CrossRef Feinstein AR (1970) The pre-therapeutic classification of co-morbidity in chronic disease. J Chron Dis 23:455–469CrossRef
5.
Zurück zum Zitat Gijsen R, Hoeymans N, Schellevis FG, et al (2001) Causes and consequences of comorbidity, a review. J Clin Epidemiol 54:661–674CrossRefPubMed Gijsen R, Hoeymans N, Schellevis FG, et al (2001) Causes and consequences of comorbidity, a review. J Clin Epidemiol 54:661–674CrossRefPubMed
6.
Zurück zum Zitat Charlson ME, Pompei P, Ales KL, et al (1987) A new method of classification prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis 40:373–383CrossRefPubMed Charlson ME, Pompei P, Ales KL, et al (1987) A new method of classification prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis 40:373–383CrossRefPubMed
7.
Zurück zum Zitat Kaplan MH, Feinstein AR (1974) The importance of classifying initial comorbidity I elevating the outcome of diabetes mellitus. J Chron Dis 242:291–298 Kaplan MH, Feinstein AR (1974) The importance of classifying initial comorbidity I elevating the outcome of diabetes mellitus. J Chron Dis 242:291–298
8.
Zurück zum Zitat Yancik R, Wesley MN, Ries LA, et al (1998) Comorbidity and age as predictors of risk for early mortality of male and female colon cancer patients. Cancer 82:2123–2134CrossRefPubMed Yancik R, Wesley MN, Ries LA, et al (1998) Comorbidity and age as predictors of risk for early mortality of male and female colon cancer patients. Cancer 82:2123–2134CrossRefPubMed
9.
Zurück zum Zitat Linn BS, Linn MW, Gurel L (1968) Cumulative illness rating scale. J Am Geriatr Soc 16:622–666PubMed Linn BS, Linn MW, Gurel L (1968) Cumulative illness rating scale. J Am Geriatr Soc 16:622–666PubMed
10.
Zurück zum Zitat Satariano WA, Ragland DR (1994) The effect of co-morbidity on 3 year survival of women with primary breast cancer. Ann Intern Med 120:104–110PubMed Satariano WA, Ragland DR (1994) The effect of co-morbidity on 3 year survival of women with primary breast cancer. Ann Intern Med 120:104–110PubMed
11.
Zurück zum Zitat Newschaffer CJ, Penberthy L, Desch CE, et al (1996) The effect of age and comorbidity in the treatment of elderly women with nonmetastatic breast cancer. Arch Intern Med 156:85–90CrossRefPubMed Newschaffer CJ, Penberthy L, Desch CE, et al (1996) The effect of age and comorbidity in the treatment of elderly women with nonmetastatic breast cancer. Arch Intern Med 156:85–90CrossRefPubMed
12.
Zurück zum Zitat Silliman RA, Troyan SL, Guadagnoli E, et al (1997) The impact of age, material status and physician-patient interactions on the care of older women with breast carcinoma. Cancer 20:1326–1334CrossRef Silliman RA, Troyan SL, Guadagnoli E, et al (1997) The impact of age, material status and physician-patient interactions on the care of older women with breast carcinoma. Cancer 20:1326–1334CrossRef
13.
Zurück zum Zitat Extermann M, Overcash J, Lyman GH, et al (1998) Comorbidity and functional status are independent in older cancer patient. J Clin Oncol 16:1582–1587PubMed Extermann M, Overcash J, Lyman GH, et al (1998) Comorbidity and functional status are independent in older cancer patient. J Clin Oncol 16:1582–1587PubMed
14.
Zurück zum Zitat Engel J, Nagel G, Breuer E, et al (2002) Primary breast cancer therapy in six regions of Germany. Eur J Cancer 38:578–585CrossRefPubMed Engel J, Nagel G, Breuer E, et al (2002) Primary breast cancer therapy in six regions of Germany. Eur J Cancer 38:578–585CrossRefPubMed
15.
Zurück zum Zitat International Union against Cancer (UICC) (1997) TNM classification of malignant tumours, 5th edn. Wiley, New York International Union against Cancer (UICC) (1997) TNM classification of malignant tumours, 5th edn. Wiley, New York
16.
Zurück zum Zitat D’Hoore W, Bouckaert A, Tilquin C (1996) Practical considerations on the use of the Charlson index with administrative data bases. J Clin Epidemiol 49:1429–1433CrossRefPubMed D’Hoore W, Bouckaert A, Tilquin C (1996) Practical considerations on the use of the Charlson index with administrative data bases. J Clin Epidemiol 49:1429–1433CrossRefPubMed
17.
Zurück zum Zitat Cox DR (1972) Regression models and life-tables. J R Stat Soc 34:187–220 Cox DR (1972) Regression models and life-tables. J R Stat Soc 34:187–220
18.
Zurück zum Zitat Tammemagi CM, Neslund-Dudas C, Simoff M, et al (2003) Impact of comorbidity on lung cancer survival. Int J Cancer 103:792–802CrossRefPubMed Tammemagi CM, Neslund-Dudas C, Simoff M, et al (2003) Impact of comorbidity on lung cancer survival. Int J Cancer 103:792–802CrossRefPubMed
19.
Zurück zum Zitat Newschaffer CJ, Bush TL, Penberthy LE, et al (1998) Does comorbidity diseases interact with cancer? An epidemiologic analysis of mortality in a cohort of elderly breast cancer patients. J Gerontol A Biol Sci Med Sci 53A:372–378 Newschaffer CJ, Bush TL, Penberthy LE, et al (1998) Does comorbidity diseases interact with cancer? An epidemiologic analysis of mortality in a cohort of elderly breast cancer patients. J Gerontol A Biol Sci Med Sci 53A:372–378
20.
21.
Zurück zum Zitat Diab SG, Elledge RM, Cark RM (2000) Tumor characteristics and clinical outcome of elderly women with breast cancer. J Natl Cancer Inst 92:550–556CrossRefPubMed Diab SG, Elledge RM, Cark RM (2000) Tumor characteristics and clinical outcome of elderly women with breast cancer. J Natl Cancer Inst 92:550–556CrossRefPubMed
22.
Zurück zum Zitat Olge KS, Swanson GM, Woods N, Azzouz F (2000) Cancer and comorbidity-redefining chronic diseases. Cancer 88:653–663CrossRefPubMed Olge KS, Swanson GM, Woods N, Azzouz F (2000) Cancer and comorbidity-redefining chronic diseases. Cancer 88:653–663CrossRefPubMed
23.
Zurück zum Zitat Rossner S (2002) Obesity: the disease of the twenty-first century. Int J Obes Relat Metab Disord 26 [Suppl 4]:S2–4 Rossner S (2002) Obesity: the disease of the twenty-first century. Int J Obes Relat Metab Disord 26 [Suppl 4]:S2–4
24.
Zurück zum Zitat Terry PD, Rohan TE (2002) Cigarette smoking and the risk of breast cancer in women: a review of the literature. Cancer Epidemiol Biomarkers Prev 11:953–971PubMed Terry PD, Rohan TE (2002) Cigarette smoking and the risk of breast cancer in women: a review of the literature. Cancer Epidemiol Biomarkers Prev 11:953–971PubMed
25.
Zurück zum Zitat Hamerman D (1999) Toward an understanding of frailty. Ann Intern Med 130:945–950PubMed Hamerman D (1999) Toward an understanding of frailty. Ann Intern Med 130:945–950PubMed
26.
Zurück zum Zitat Yancik R, Havlik RJ, Wesley MN, et al (1996) Cancer and comorbidity in older patients: a descriptive profile. Ann Epidemiol 6:399–412CrossRefPubMed Yancik R, Havlik RJ, Wesley MN, et al (1996) Cancer and comorbidity in older patients: a descriptive profile. Ann Epidemiol 6:399–412CrossRefPubMed
27.
Zurück zum Zitat Vaeth PA, Satariano WA, Ragland DR (2000) Limiting comorbid conditions and breast cancer at diagnosis. J Gerontol 55:M593–600 Vaeth PA, Satariano WA, Ragland DR (2000) Limiting comorbid conditions and breast cancer at diagnosis. J Gerontol 55:M593–600
28.
Zurück zum Zitat Coebergh JW, Janssen-Heijnen ML, Post PN, et al (1999) Serious co-morbidity among unselected cancer patients newly diagnosed in the southeastern part of The Netherlands in 1993–1996. J Clin Epidemiol 52:1131–1136CrossRefPubMed Coebergh JW, Janssen-Heijnen ML, Post PN, et al (1999) Serious co-morbidity among unselected cancer patients newly diagnosed in the southeastern part of The Netherlands in 1993–1996. J Clin Epidemiol 52:1131–1136CrossRefPubMed
29.
Zurück zum Zitat Taplin SH, Barlow W, Urban N, et al (1995) Stage, age comorbidity, and direct costs of colon, prostate, and breast cancer. Care J Natl Cancer Inst 87:417–426 Taplin SH, Barlow W, Urban N, et al (1995) Stage, age comorbidity, and direct costs of colon, prostate, and breast cancer. Care J Natl Cancer Inst 87:417–426
30.
Zurück zum Zitat Nicolucci A, Mainini F, Penna A, et al (1993) The influence of patients characteristics on the appropriateness of surgical treatment for breast cancer patients. Ann Oncol 4:133–140PubMed Nicolucci A, Mainini F, Penna A, et al (1993) The influence of patients characteristics on the appropriateness of surgical treatment for breast cancer patients. Ann Oncol 4:133–140PubMed
31.
Zurück zum Zitat Guadagnoli E, Shapiro C, Gurwitz JH, et al (1997) Age-related patterns of care: evidence against ageism in the treatment of early stage breast cancer. J Clin Oncol 15:2338–2344PubMed Guadagnoli E, Shapiro C, Gurwitz JH, et al (1997) Age-related patterns of care: evidence against ageism in the treatment of early stage breast cancer. J Clin Oncol 15:2338–2344PubMed
32.
Zurück zum Zitat Nagel G, Röhrig B, Hoyer H, et al (2003) A population-based study on variations in the use of adjuvant systemic therapy on postmenopausal patients with early stage breast cancer. J Cancer Res Clin Oncol 129:183–191PubMed Nagel G, Röhrig B, Hoyer H, et al (2003) A population-based study on variations in the use of adjuvant systemic therapy on postmenopausal patients with early stage breast cancer. J Cancer Res Clin Oncol 129:183–191PubMed
33.
Zurück zum Zitat Hébert-Croteau N, Brisson J, Latreille J, et al (1999) Compliance with consensus recommendations for the treatment of early stage breast carcinoma in elderly women. Cancer 85:1104–1113CrossRefPubMed Hébert-Croteau N, Brisson J, Latreille J, et al (1999) Compliance with consensus recommendations for the treatment of early stage breast carcinoma in elderly women. Cancer 85:1104–1113CrossRefPubMed
34.
Zurück zum Zitat Mandelblatt JS, Hadley J, Kerner JF, et al (2000) Patterns of breast carcinoma treatment in older women. Cancer 89:561–573CrossRefPubMed Mandelblatt JS, Hadley J, Kerner JF, et al (2000) Patterns of breast carcinoma treatment in older women. Cancer 89:561–573CrossRefPubMed
35.
36.
Zurück zum Zitat Newschaffer CJ, Bush TL, Penberthy LT (1997) Comorbidity measurement in elderly females breast cancer patients with administrative and medical record data. J Clin Epidemiol 50:725–733CrossRefPubMed Newschaffer CJ, Bush TL, Penberthy LT (1997) Comorbidity measurement in elderly females breast cancer patients with administrative and medical record data. J Clin Epidemiol 50:725–733CrossRefPubMed
37.
Zurück zum Zitat Klabunde CN, Potosky AL, Legler JM, et al (2000) Development of a comorbidity index using physician claims data. J Clin Epidemiol 53:1258–1267CrossRefPubMed Klabunde CN, Potosky AL, Legler JM, et al (2000) Development of a comorbidity index using physician claims data. J Clin Epidemiol 53:1258–1267CrossRefPubMed
38.
Zurück zum Zitat Extermann M (2000) Measurement and impact of comorbidity in older cancer patients. Crit Rev Oncol Hematol 35:181–200CrossRefPubMed Extermann M (2000) Measurement and impact of comorbidity in older cancer patients. Crit Rev Oncol Hematol 35:181–200CrossRefPubMed
39.
Zurück zum Zitat Lash TL, Thwin SS, Horton NJ, et al (2003) Multiple informants: a new method to assess breast cancer patients’ comorbidity. Am J Epidemiol 153:249–257CrossRef Lash TL, Thwin SS, Horton NJ, et al (2003) Multiple informants: a new method to assess breast cancer patients’ comorbidity. Am J Epidemiol 153:249–257CrossRef
Metadaten
Titel
The impact of comorbidity on the survival of postmenopausal women with breast cancer
verfasst von
G. Nagel
U. Wedding
H. Hoyer
B. Röhrig
D. Katenkamp
Publikationsdatum
01.11.2004
Verlag
Springer-Verlag
Erschienen in
Journal of Cancer Research and Clinical Oncology / Ausgabe 11/2004
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-004-0594-3

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