Lung cancer is the leading cause of cancer associated mortality in the US.
1.Majority of patients with lung cancer are diagnosed with advanced stage cancer and median age at diagnosis is 70 years. The prevalence of comorbidity increases with age and older patients with lung cancer have a particularly high burden, given the common association with smoking. Based on recent data from the US, the vast majority of adults 65 years or older have significant and often multiple comorbid conditions: hypertension (73%), chronic obstructive pulmonary disease (57%), ischemic heart disease (53%), diabetes (32%), congestive cardiac failure (31%), chronic kidney disease (30%), and depression (21%).
- Siegel R.L.
- Miller K.D.
- Jemal A.
Cancer statistics, 2016.
CA Cancer J Clin. 2016 Jan; 66 (Epub 2016 Jan 7 PubMed PMID: 26742998): 7-30https://doi.org/10.3322/caac.21332
2.Since the prognosis in older adults with advanced non-small cell lung cancer (NSCLC) is particularly poor, it is essential to capture the “host” factors that render management of this disease challenging. Many elderly do not receive treatment for advanced NSCLC.
- CMS administrative claims data
from the Chronic Condition Warehouse (CCW).
3.This is largely attributed to poor performance status (PS), a high comorbid disease burden, or a combination thereof. The thoracic medical oncologist typically relies on Eastern Cooperative Oncology Group (ECOG) PS for decision making regarding chemotherapy. The relative contribution of underlying comorbid disease and cancer in defining PS is undetermined. Recent ASCO guidelines allude to the importance of comorbidity (described as multiple chronic conditions, MCC) and acknowledge the lack of high level of evidence available for decision making in the setting of MCC.
- Owonikoko T.K.
- Ragin C.C.
- Belani C.P.
- Oton A.B.
- Gooding W.E.
- Taioli E.
- Ramalingam S.S.
Lung cancer in elderly patients: an analysis of the surveillance,epidemiology, and end results database.
J Clin Oncol. 2007 Dec 10; 25: 5570-5577
- Masters G.A.
- Temin S.
- Azzoli C.G.
- Giaccone G.
- Baker Jr., S.
- Brahmer J.R.
- Ellis P.M.
- Gajra A.
- Rackear N.
- Schiller J.H.
- Smith T.J.
- Strawn J.R.
- Trent D.
- DH Johnson
Systemic therapy for stage IV non-small-cell lung cancer: American Society of Clinical Oncology Clinical Practice guideline update.
J Clin Oncol. 2015 Oct 20; 33: 3488-3515
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Geriatric Oncology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Cancer statistics, 2016.CA Cancer J Clin. 2016 Jan; 66 (Epub 2016 Jan 7 PubMed PMID: 26742998): 7-30https://doi.org/10.3322/caac.21332
- from the Chronic Condition Warehouse (CCW).
- Lung cancer in elderly patients: an analysis of the surveillance,epidemiology, and end results database.J Clin Oncol. 2007 Dec 10; 25: 5570-5577
- Systemic therapy for stage IV non-small-cell lung cancer: American Society of Clinical Oncology Clinical Practice guideline update.J Clin Oncol. 2015 Oct 20; 33: 3488-3515
- Comparing comorbidity scales: attending physician score versus the Cumulative Illness Rating Scale for Geriatrics.J Geriatr Oncol. 2015 Dec 28; (pii: S1879-4068(15)00323–9)
- A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.J Chronic Dis. 1987; 40: 373-383
- Cumulative illness rating scale.J Am Geriatr Soc. 1968; 16: 622-626
- The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire.J Gerontol. 1981; 36: 428-434
- A new simplified comorbidity score as a prognostic factor in non-small-cell lung cancer patients: description and comparison with the Charlson's index.Br J Cancer. 2005 Nov 14; 93: 1098-1105
- Prognostic importance of comorbidity in a hospital-based cancer registry.JAMA. 2004; 291: 22
- Quality of life and comorbidity score as prognostic determinants in non-small-cell lung cancer patients.Ann Oncol. 2008 Aug; 19: 1458-1464
- Comorbidity assessment using Charlson comorbidity index and simplified comorbidity score and its association with clinical outcomes during first-line chemotherapy for lung cancer.Clin Lung Cancer. 2015 Oct 22; (pii: S1525-7304(15)00262–4)
- Comorbidity and survival in lung cancer patients.Cancer Epidemiol Biomarkers Prev. 2015 Jul; 24 (Epub 2015 Jun 11 PubMed PMID: 26065838): 1079-1085https://doi.org/10.1158/1055-9965.EPI-15-0036
- Comorbidity and survival of Danish lung cancer patients from 2000 to 2011: a population-based cohort study.Clin Epidemiol. 2013 Nov 1; 5: 31-38
- Impact of comorbidity on lung cancer survival.Int J Cancer. 2003 Mar 1; 103: 792-802
- Impact of comorbidities on clinical outcomes in non-small cell lung cancer patients who are elderly and/or have poor performance status.Crit Rev Oncol Hematol. 2010 Oct; 76: 53-60
- Prognostic impact of comorbidity in elderly lung cancer patients: use and comparison of two scores.Lung Cancer. 2011 Apr; 72: 108-113
- Predictive ability of Charlson comorbidity index on outcomes from lung cancer.Am J Clin Oncol. 2011 Dec; 34: 593-596
- Pretreatment quality of life and functional status assessment significantly predict survival of elderly patients with advanced non-small-cell lung cancer receiving chemotherapy: a prognostic analysis of the multicenter Italian lung cancer in the elderly study.J Clin Oncol. 2005 Oct 1; 23: 6865-6872
- Phase III study by the Norwegian lung cancer study group: pemetrexed plus carboplatin compared with gemcitabine plus carboplatin as first-line chemotherapy in advanced non-small-cell lung cancer.J Clin Oncol. 2009 Jul 1; 27 (Epub 2009 May 11 PubMed PMID: 19433683): 3217-3224https://doi.org/10.1200/JCO.2008.20.9114
- Influence of comorbidity on survival, toxicity and health-related quality of life in patients with advanced non-small-cell lung cancer receiving platinum-doublet chemotherapy.Eur J Cancer. 2010 Aug; 46: 2225-2234
- Advanced non-small cell lung cancer in the elderly: the impact of age and comorbidities on treatment modalities and patient prognosis.J Geriatr Oncol. 2015 Jan; 6: 38-45
- Comparison of scoring methods for ACE-27: simpler Is better.J Geriatr Oncol. 2012 Jul 1; 3: 238-245
Published online: March 03, 2016
Accepted: February 1, 2016
Received: January 26, 2016(Editorial accompanies Kirkhus et al. “Comparing comorbidity scales: Attending physician score versus the Cumulative Illness Rating Scale for Geriatrics")
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
ScienceDirectAccess this article on ScienceDirect
- Comparing comorbidity scales: Attending physician score versus the Cumulative Illness Rating Scale for GeriatricsJournal of Geriatric OncologyVol. 7Issue 2