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 journalArticlepeer-review

    5 Citations (Scopus)

    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
    Publication statusPublished - 2020 Jan 1

    Keywords

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

    ASJC Scopus subject areas

    • Oncology
    • Cancer Research

    Fingerprint

    Dive into the research topics of 'The age-adjusted Charlson comorbidity index as a predictor of overall survival of surgically treated non-metastatic clear cell renal cell carcinoma'. Together they form a unique fingerprint.

    Cite this