Longitudinal Trends of Comorbidities and Survival Among Kidney Cancer Patients in Asian Population

IF 2.9 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2024-11-19 DOI:10.1002/cam4.70421

Minji Jung, Eunjung Choo, Jinhui Li, Zhengyi Deng, Marvin E. Langston, Sukhyang Lee, Benjamin I. Chung

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Abstract

Background

Comorbidity could influence cancer diagnosis, treatment, prognosis, or survival. Although comorbidity burden in kidney cancer patients is high, limited evidence exists on the longitudinal patterns of individual comorbidity prevalence and its impact on overall survival among kidney cancer patients, particularly in Asian populations.

Methods

We included adults diagnosed with kidney cancer between 2010 and 2021 using the Korean nationwide health insurance database. Comorbidities assessed were any 1 of 19 specific medical conditions, diagnosed within 1 year prior to cancer diagnosis. We calculated the incidence and age-standardized incidence rate of kidney cancer, prevalence of individual medical conditions as single or multiple comorbidities, and overall survival probability of kidney cancer patients over a 12-year period. We estimated the odds ratio (OR) of having individual and multiple comorbidities with age and sex as independent covariates and adjusted for other comorbidities. Kaplan–Meier curves were used for overall survival at different time frames up to 5 years of follow-up.

Results

Among kidney cancer patients (N = 42,740), 68.7% were men, and median (interquartile range) age was 59 (49–68) years. Approximately 76% of patients had at least one comorbidity at the time of cancer diagnosis. Overall, hypertension (51.3%), dyslipidemia (40.2%), mild liver disease (27.4%), diabetes (25.1%), and peptic ulcer disease (18.9%) were the most prevalent comorbidities. The proportion of patients having three or more comorbidities continuously increased from 2010 (29.4%) to 2021 (44.9%). Having more comorbidities was associated with a lower probability of overall survival.

Conclusion

Comorbidities were prevalent in kidney cancer patients, and the proportions of patients with multiple conditions increased over time. Although survival probability increased over time, it was attenuated by having more comorbidities. Our data emphasizes the importance of comprehensive management for both cancer and comorbid conditions in kidney cancer patients.

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亚洲肾癌患者的并发症和生存期纵向趋势

背景：合并症可能会影响癌症的诊断、治疗、预后或生存。虽然肾癌患者的合并症负担很重，但关于肾癌患者中个人合并症流行率的纵向模式及其对总体生存的影响的证据却很有限，尤其是在亚洲人群中：我们利用韩国全国医疗保险数据库纳入了 2010 年至 2021 年间确诊为肾癌的成年人。所评估的合并症是在癌症确诊前 1 年内诊断出的 19 种特定疾病中的任何一种。我们计算了肾癌的发病率和年龄标准化发病率、单个或多个合并症的患病率以及肾癌患者在 12 年内的总体生存概率。我们以年龄和性别作为独立的协变量，并对其他合并症进行调整，估算了患有单项和多项合并症的几率比（OR）。我们使用卡普兰-梅耶曲线计算了随访 5 年以内不同时间段的总生存率：在肾癌患者（N = 42 740）中，68.7%为男性，年龄中位数（四分位数间距）为59（49-68）岁。约 76% 的患者在确诊癌症时至少患有一种合并症。总体而言，高血压（51.3%）、血脂异常（40.2%）、轻度肝病（27.4%）、糖尿病（25.1%）和消化性溃疡病（18.9%）是最常见的合并症。从 2010 年（29.4%）到 2021 年（44.9%），患有三种或三种以上合并症的患者比例持续上升。合并症越多，总生存概率越低：结论：合并症在肾癌患者中很普遍，且患有多种疾病的患者比例随着时间的推移而增加。虽然随着时间的推移生存概率会增加，但合并症越多，生存概率越低。我们的数据强调了对肾癌患者进行癌症和合并症综合治疗的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.