title: The Influence of Comorbidity and the Simplified Comorbidity Score on Overall Survival in Non-Small Cell Lung Cancer-A Prospective Cohort Study.
abstract: We addressed the uncertainty of comorbidity as a prognosticator by evaluating comorbidity and the Simplified Comorbidity Score (SCS) as predictors of overall survival in non-small cell lung cancer (NSCLC).
  
  
  
  A prospective study included patients in whom NSCLC was diagnosed at an Australian cancer hospital between 2012 and 2014. Patients were assessed for SCS at recruitment and followed up every 3 months until death.
  
  
  
  The cohort included 633 patients; their median age was 67 years (range 28-93), 63% were male, and 86% were ever-smokers. The median SCS at enrolment was 8 (range 0-19); 20% had an SCS higher than 9, and 11% had an SCS of 0. An SCS higher than 9 was associated with male sex, age older than 75 years, an Eastern Cooperative Oncology Group performance status of 2 or higher, and fewer cancer treatments. The 1-year overall survival rate was 62% (95% confidence interval: 58-66). In multivariate analysis, the strongest associations with mortality were metastatic disease (hazard ratio [HR] = 2.8, p < 0.01), Eastern Cooperative Oncology Group performance status of 2 or higher (HR = 2.0, p < 0.01), male sex (HR = 1.6, p < 0.01), more than 10% weight loss at diagnosis (HR = 1.5, p < 0.01), and age older than 75 years (HR = 1.5, p = 0.01). An SCS higher than 9 was not associated with overall survival (HR = 1.0, p = 0.8), and the effect of continuous SCS (HR = 1.1, p < 0.01) was explained by smoking status.
  
  
  
  In this cohort of patients with NSCLC the SCS was not a clinically significant predictor of overall survival over and above basic patient and disease factors.
authors: Department of Epidemiology and Preventive Medicine, Monash University Melbourne, Australia; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia. Electronic address: Marliese.Alexander@petermac.org.
authors: Marliese
authors: M
authors: Alexander
authors: Department of Epidemiology and Preventive Medicine, Monash University Melbourne, Australia.
authors: Sue M
authors: SM
authors: Evans
authors: Department of Epidemiology and Preventive Medicine, Monash University Melbourne, Australia; Department of Allergy Immunology and Respiratory Medicine, Alfred Health, Melbourne, Australia.
authors: Robert G
authors: RG
authors: Stirling
authors: Department of Epidemiology and Preventive Medicine, Monash University Melbourne, Australia.
authors: Rory
authors: R
authors: Wolfe
authors: Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Radiation Oncology (Lung Service), Peter MacCallum Cancer Centre, Melbourne, Australia.
authors: Ann
authors: A
authors: Officer
authors: Department of Radiation Oncology (Lung Service), Peter MacCallum Cancer Centre, Melbourne, Australia.
authors: Michael
authors: M
authors: MacManus
authors: Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia.
authors: Benjamin
authors: B
authors: Solomon
authors: Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, Australia.
authors: Kate
authors: K
authors: Burbury
authors: Department of Radiation Oncology (Lung Service), Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia.
authors: David
authors: D
authors: Ball
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate
keywords: Comorbidity; Lung cancer; Risk score; Simplified comorbidity score; Survival