How does comorbidity affect colon cancer patients’ care trajectory? Results from the French EvaCCoR cohort study - 16/01/21
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Highlights |
• | The comorbidity effect on colon patients’ management is supported by many studies. |
• | No studies in France have included both care trajectory and survival analysis. |
• | We confirmed the detrimental effect of comorbidity on patients’ management. |
• | We found comorbidity to affect survival mainly directly but also indirectly. |
• | We found comorbidity may affect survival via its impact on chemotherapy delivery. |
Summary |
Objective |
Due to their advanced age in average, colon cancer patients are likely to be exposed to comorbidity. However, the influence of comorbidity on patients’ care trajectory and survival is largely under-explored. Hence, we investigate the effect of comorbidity on patients care trajectory and survival based on an observational study in “real-life” setting.
Methods |
This prospective observational study in two French regions includes patients aged over 18 and firstly treated for a colon cancer, stage II and III, diagnosed between 1st January and 31st December 2010. We assessed the influence of comorbidity (severe vs moderate or none), using the Charlson Comorbidity Index, on overall survival and patients’ management steps.
Results |
We analyzed 762 patients. We found comorbidity to be associated with adjuvant treatment delivery with a longer delay between surgery and chemotherapy initiation among patients with severe comorbidity. Severe comorbidity had an independent detrimental effect on overall survival that is slightly downsized after adjustment for adjuvant treatment delivery.
Conclusion |
Using observational “real-life” data, we showed that comorbidity impacts the colon cancer patients’ care trajectory directly but also through indirect pathways involving adjuvant chemotherapy delivery. However, further studies are needed to better understand this mechanism.
Le texte complet de cet article est disponible en PDF.Keywords : Comorbidity, Colon cancer, Care trajectory, Cohort study
Plan
Vol 45 - N° 1
Article 101422- janvier 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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