title: Patients with soft tissue sarcoma comprise a higher probability of comorbidities than cancer-free individuals. A secondary data analysis.
abstract: Soft tissue sarcoma comprises a heterogeneous group of solid malignant tumours. Comorbidities are important prognostic factors for survival and adversely impact quality of life. We examined the complex relationship between soft tissue sarcoma and comorbidities over time in a large population-based sample. The study uses routine data from the German statutory healthcare system (n = 2,615,865). Case identification of soft tissue sarcoma and comorbid diseases was based on ICD-10 codes and diagnostic modifiers. Uni- and multivariate regression models were used to obtain risk estimates for chronic somatic and mental comorbidities in soft tissue sarcoma patients compared to a cancer-free control group. At diagnosis, patients with soft tissue sarcoma were significantly more likely to be affected with prevalent bronchial asthma, ≥1 cardiovascular risk factor (hypertension, angina pectoris, heart failure, peripheral arterial disease and thrombosis), back pain, depression, anxiety disorder and adjustment disorder than cancer-free controls. During the course of disease, sarcoma patients were at a significantly higher risk to develop incident depression, anxiety disorder and adjustment disorder. Comorbidities need to be considered in clinical decision making regarding the treatment of soft tissue sarcoma patients. Psycho-oncological treatment should be incorporated into medical care of patients with sarcoma.
authors.affiliation: Center for Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany.|National Center for Tumor Diseases (NCT) (partner site) Dresden and German Cancer Research Center (DKFZ), Dresden, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Trautmann
authors.affiliation: Department of Medical Biostatistics, Epidemiology and Informatics, University of Mainz, Mainz, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Singer
authors.affiliation: Center for Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany.|National Center for Tumor Diseases (NCT) (partner site) Dresden and German Cancer Research Center (DKFZ), Dresden, Germany.|University Cancer Center, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Schmitt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012509:Sarcoma / Q000150:complications*; D012983:Soft Tissue Neoplasms / Q000150:complications*; D055815:Young Adult
keywords: Health Services Research; burden of illness; comorbidity; outcomes assessment; soft tissue sarcoma