文章：

查尔森-德约共病指数作为非肌层浸润性膀胱癌复发的新型预测因子

Charlson–Deyo Comorbidity Index as a Novel Predictor for Recurrence in Non-Muscle-Invasive Bladder Cancer

原文发布日期：8 December 2023

DOI: 10.3390/cancers15245770

类型: Article

开放获取: 是

英文摘要：

Purpose: To test the association between the Charlson–Deyo Comorbidity Index (CCI) and the recurrence of non-muscle-invasive bladder cancer (NMIBC). Methods: NMIBC (Ta, T1, TIS) patients who underwent transurethral resection of bladder tumor (TURB) between 2010 and 2018 were identified within a retrospective data repository of a large university hospital. Kaplan–Meier estimates and uni- and multivariable Cox regression models tested for differences in risk of recurrence according to low vs. high comorbidity burden (CCI ≤ 4 vs. >4) and continuously coded CCI. Results: A total of 1072 NMIBC patients were identified. The median follow-up time of the study population was 55 months (IQR 29.6–79.0). Of all 1072 NMIBC patients, 423 (39%) harbored a low comorbidity burden vs. 649 (61%) with a high comorbidity burden. Overall, the rate of recurrence was 10% at the 12-month follow-up vs. 22% at the 72-month follow-up. In low vs. high comorbidity burden groups, rates of recurrence were 6 vs. 12% at 12 months and 18 vs. 25% at 72 months of follow-up (p= 0.02). After multivariable adjustment, a high comorbidity burden (CCI > 4) independently predicted a higher risk of recurrence (HR 1.42, 95% confidence interval (CI) 1.06–1.92,p= 0.018). After multivariable adjustment, the hazard of recurrence increased by 5% per each one-unit increase on the CCI scale (HR 1.05, 95% CI 1.00–1.10,p= 0.04). Conclusions: Comorbidities in NMIBC patients are common. Our data suggest that patients with higher CCI have an increased risk of BC recurrence. As a consequence, patients with a high comorbidity burden should be particularly encouraged to adhere to NMIBC guidelines and conform to follow-up protocols.

摘要翻译： 

目的：检验查尔森-德耶合并症指数（CCI）与非肌层浸润性膀胱癌（NMIBC）复发之间的关联。方法：通过回顾性数据资料库，识别2010年至2018年间在一所大型大学医院接受经尿道膀胱肿瘤切除术（TURB）的NMIBC（Ta、T1、TIS期）患者。采用Kaplan-Meier估计以及单变量和多变量Cox回归模型，根据低合并症负担与高合并症负担（CCI ≤ 4 对比 >4）以及连续编码的CCI，检验复发风险的差异。结果：共识别出1072名NMIBC患者。研究人群的中位随访时间为55个月（IQR 29.6–79.0）。在所有1072名NMIBC患者中，423名（39%）为低合并症负担，649名（61%）为高合并症负担。总体而言，12个月随访时的复发率为10%，而72个月随访时的复发率为22%。在低合并症负担组与高合并症负担组中，12个月随访时的复发率分别为6%和12%，72个月随访时的复发率分别为18%和25%（p=0.02）。经多变量调整后，高合并症负担（CCI > 4）独立预测了更高的复发风险（HR 1.42，95%置信区间（CI）1.06–1.92，p=0.018）。经多变量调整后，CCI量表每增加一个单位，复发风险增加5%（HR 1.05，95% CI 1.00–1.10，p=0.04）。结论：NMIBC患者中合并症较为常见。我们的数据表明，CCI较高的患者膀胱癌复发风险增加。因此，应特别鼓励高合并症负担的患者遵循NMIBC指南并遵守随访方案。

原文链接：

Charlson–Deyo Comorbidity Index as a Novel Predictor for Recurrence in Non-Muscle-Invasive Bladder Cancer