title: Evaluation of the effect of comorbidity on survival in pancreatic cancer by using "Charlson Comorbidity Index" and "Cumulative Illness Rating Scale".
abstract: BACKGROUND
  Effect of comorbidity on the treatments that patients receive is not clear, as healthy elderly patients and the elderly with less comorbid diseases are included in the studies. In the present study, the effect of comorbidity on the survival was evaluated using Charlson Comorbidity Index (CCI) and Cumulative Illness Rating Scale (CIRS).
  
  
  METHODS
  The general features and comorbid diseases of the pancreatic cancer patients were retrospectively screened from the patient files using the automated system. CCI and CIRS were used as the comorbidity indices.
  
  
  RESULTS
  A total of 106 patients with pancreatic cancer were included in the study. The median overall survival rate was 9.0 [95 % confidence interval (CI): 6.7-11.3] months. The median overall survival rate was found as 9.4 (95 % CI: 6.7-12.1) months in the patients whose CCI score was ≤ 2 and was found as 6.2 (95 % CI: 4.0-8.3) months in the patients with CCI scores ≥ 3 (p = 0.05). The median overall survival rate was calculated as 9.8 (95 % CI: 6.3-13.4) months in the patients with CIRS scores ≤ 2 and was calculated as 8.3 (95 % CI: 6.0-10.6) months in the patients with CIRS scores ≥ 3 (p = 0.51). When surgery, radiotherapy, grading, and CCI score were evaluated using multivariate analysis, it was observed that only the treatment modality had a significant effect on the survival rate.
  
  
  CONCLUSIONS
  The results on the use of comorbidity indices are contradictory for the cancers with lower survival rates such as pancreatic cancer. New prognostic scales might be developed for this patient group by considering the side effects of chemotherapy.
authors.affiliation: Department of Medical Oncology, Kahramanmaras Sutcu Imam University Faculty of Medicine, 46000, Merkez, Kahramanmaras, Turkey, tugbasan@yahoo.com.
authors.forename: F Tugba
authors.initials: FT
authors.lastname: Kos
authors.forename: Ozan
authors.initials: O
authors.lastname: Yazici
authors.forename: Burak
authors.initials: B
authors.lastname: Civelek
authors.forename: Metin
authors.initials: M
authors.lastname: Seker
authors.forename: Zafer
authors.initials: Z
authors.lastname: Arik
authors.forename: Sercan
authors.initials: S
authors.lastname: Aksoy
authors.forename: Dogan
authors.initials: D
authors.lastname: Uncu
authors.forename: Nuriye
authors.initials: N
authors.lastname: Ozdemir
authors.forename: Nurullah
authors.initials: N
authors.lastname: Zengin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality*; D015897:Comorbidity; D048909:Diabetes Complications / Q000401:mortality*; D004066:Digestive System Diseases / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000401:mortality*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index; D013534:Survival; D014421:Turkey / Q000453:epidemiology