Prognostic impact of comorbidity among long-term breast cancer survivors: Results from the LACE study
Cancer Epidemiology, Biomarkers & Prevention, 06/12/2012
Braithwaite D et al. – The CCI was independently associated with lower overall and nonbreast cancer survival, but not with breast cancer–specific survival.Methods
- We studied a prospective cohort of 2,272 women with breast cancer, who were recruited following initial breast cancer treatment.
- Associations of the Charlson comorbidity index (CCI) and hypertension with survival were evaluated in delayed entry Cox proportional hazards models.
- During a median follow-up of nine years, higher CCI scores were independently associated with an increased risk of death from all causes [HR, 1.32; 95% confidence interval (CI), 1.13–1.54] and from nonbreast cancer causes (HR, 1.55; 95% CI, 1.19–2.02), but not from breast cancer (HR, 1.14; 95% CI, 0.93–1.41).
- Hypertension was independently associated with an increased risk of death from all causes (HR, 1.55; 95% CI, 1.20–1.99), from nonbreast cancer causes (HR, 1.67; 95% CI, 1.10–2.54), and from breast cancer (HR, 1.47; 95% CI, 1.03–2.09), but these associations were no longer significant after adjustment for antihypertensive medication.
- The relationship between the CCI and overall survival was the strongest among women with stage I disease (stage I, HR, 1.65; 95% CI, 1.26–2.16 vs. stage III, HR, 0.53; 95% CI, 0.23–1.25).