Prevalence and prognostic impact of comorbidity in soft tissue sarcoma: A population-based cohort study

Figures & data

Table I. Patient characteristics by Charlson’s Comorbidity score (N = 1210).

	N (%)	Charlson Comorbidity score N (%)
		0	1	2	3+	P
Total	1210 (100)	911 (75)	106 (9)	107 (9)	86 (7)
Age (years)
Median (range)	59 (15–95)	54 (15–95)	70 (16–91)	70 (19–93)	72 (19–87)	< 0.001
Sex
Female	580 (48)	433 (48)	47 (44)	53 (50)	47 (55)
Male	630 (52)	478 (52)	59 (56)	54 (50)	39 (45)	0.52
Year of diagnosis
1979–1988	268 (22)	222 (24)	19 (18)	19 (18)	8 (9)
1989–1998	390 (32)	302 (33)	31 (29)	33 (31)	24 (28)
1999–2008	552 (46)	387 (42)	56 (53)	55 (51)	54 (63)	0.002
Stage at diagnosis
Localized	1065 (88)	813 (89)	94 (89)	87 (81)	71 (83)
Metastatic	145 (12)	98 (11)	12 (11)	20 (19)	15 (17)	0.04
Tumor size (cm)
Median (range)*	7 (1–35)	6 (1–35)	8 (1–30)	7 (1–29)	7 (1–26)	0.81
Location
Subcutaneus	361 (30)	268 (29)	27 (25)	33 (31)	33 (38)
Subfascial	849 (70)	643 (71)	79 (75)	74 (69)	53 (62)	0.25
Malignancy grade
Low	212 (18)	174 (19)	20 (19)	6 (6)	12 (14)
Intermediate	167 (14)	140 (15)	8 (8)	11 (10)	8 (9)
High	831 (69)	597 (66)	78 (74)	90 (84)	66 (77)	0.001
Treatment
Surgery^†	1135 (94)	854 (94)	99 (93)	99 (93)	83 (97)	0.70
Wide/radical	792 (72)	622 (75)	63 (65)	59 (62)	48 (62)
Intralesional/marginal	303 (28)	204 (25)	34 (35)	36 (38)	29 (38)	0.004
Radiotherapy	375 (31)	298 (33)	33 (31)	29 (27)	15 (17)	0.02
Chemotherapy	110 (9)	95 (10)	5 (5)	6 (6)	4 (5)	0.05

N, number. *Tumor size 39, 28, 2, 3, and 6 missing values, respectively. ^†Margin: 40, 28, 2, 4, and 6 missing values, respectively.

Figure 1. Prevalence of Charlson's Comorbidity score as percentage by age (A) and calendar year of diagnosis (B).

Table II. Overall prevalence of medical conditions in the Charlson’s Comorbidity Index among soft tissue sarcoma patients in the Aarhus Sarcoma Registry (N = 1210).

Condition	N	%
Myocardial Infarct	44	3.6
Congestive heart failure	22	1.8
Peripheral vascular disease	27	2.2
Cerebrovascular disease	44	3.6
Dementia	5	0.4
Chronic pulmonary disease	47	3.9
Connective tissue disease	18	1.5
Ulcer disease	37	3.1
Mild liver disease	7	0.6
Diabetes	32	2.6
Hemiplegia	1	0.1
Moderate/severe renal disease	10	0.8
Diabetes with end organ damage	7	0.6
Any tumor*	120	9.9
Leukemia	4	0.3
Lymphoma	5	0.4
Moderate/severe liver disease	0	0.0
Metastatic solid tumor	32	2.6
AIDS	0	0.0

N, number; AIDS, acquired immunodeficiency syndrome. *Excluding tumors in soft tissue and bone (ICD-8; 170, 171, 192.49-99 and ICD-10; C40-C41, C47, C49).

Figure 2. Cumulative incidence functions of overall (A) and disease-specific mortality (B) by Charlson's Comorbidity score.

Table III. Crude and adjusted analyses for the effect of comorbidity on overall and disease-specific mortality in 1210 adult soft tissue sarcoma patients by age, sex, and calendar year of diagnosis.

	N	Overall mortality			Disease-specific mortality
		5-year (%)	HR (95% CI)		5-year (%)	HR (95% CI)
			Crude	Adjusted*		Crude	Adjusted*
Overall
No	911	35	1	1	26	1	1
Mild	106	52	1.88 (1.48–2.41)	1.56 (1.20–2.02)	33	1.37 (0.98–1.92)	1.46 (1.01–2.10)
Moderate	107	62	2.48 (1.97–3.12)	1.55 (1.20–2.00)	41	2.06 (1.53–2.78)	1.55 (1.10–2.19)
Severe	86	69	2.70 (2.10–3.46)	2.05 (1.56–2.70)	44	2.03 (1.45–2.83)	2.04 (1.39–2.99)
15–49 years
No	386	24	1	1	22	1	1
Mild	12	33	1.71 (0.75–3.87)	1.21 (0.52–2.84)	33	2.04 (0.90–4.65)	1.43 (0.60–3.44)
Moderate	17	59	3.53 (1.99–6.26)	2.99 (1.53–5.84)	59	3.85 (2.11–7.01)	3.20 (1.57–6.54)
Severe	8	40	2.46 (1.00–6.02)	8.77 (2.57–29.87)	38	1.65 (0.52–5.19)	10.77 (2.30–50.35)
50–69 years
No	322	33	1	1	27	1	1
Mild	41	39	1.28 (0.84–1.95)	1.86 (1.18–2.91)	29	0.91 (0.50–1.65)	1.63 (0.85–3.11)
Moderate	36	50	1.78 (1.17–2.71)	1.72 (1.04–2.87)	44	1.90 (1.14–3.17)	1.15 (0.57–2.33)
Severe	31	65	2.36 (1.54–3.59)	2.01 (1.27–3.19)	48	2.13 (1.26–3.61)	1.65 (0.92–2.96)
≥ 70 years
No	203	59	1	1	35	1	1
Mild	53	66	1.41 (1.01–1.98)	1.46 (1.02–2.10)	36	1.17 (0.72–1.92)	1.19 (0.68–2.07)
Moderate	54	70	1.40 (1.02–1.93)	1.18 (0.84–1.66)	33	1.23 (0.76–1.98)	0.90 (0.54–1.53)
Severe	47	77	1.50 (1.07–2.10)	1.97 (1.37–2.85)	43	1.38 (0.85–2.24)	1.93 (1.11–3.37)
Female
No	433	34	1	1	28	1	1
Mild	47	40	1.50 (1.02–2.21)	1.25 (0.82–1.88)	23	0.96 (0.54–1.69)	0.94 (0.50–1.77)
Moderate	53	68	2.71 (1.95–3.78)	1.61 (1.11–2.34)	53	2.31 (1.54–3.47)	1.47 (0.91–2.39)
Severe	47	66	2.75 (1.95–3.87)	1.94 (1.32–2.85)	49	2.01 (1.29–3.13)	1.84 (1.09–3.11)
Male
No	478	36	1	1	26	1	1
Mild	59	61	2.26 (1.65–3.10)	1.93 (1.37–2.73)	41	1.79 (1.17–2.74)	2.15 (1.34–3.44)
Moderate	54	56	2.29 (1.66–3.15)	1.60 (1.12–2.29)	30	1.80 (1.16–2.79)	1.65 (0.99–2.75)
Severe	39	72	2.68 (1.86–3.86)	2.23 (1.50–3.11)	38	2.02 (1.22–3.50)	2.50 (1.42–4.42)
1979–1988
No	222	39	1	1	31	1	1
Mild	19	68	2.14 (1.30–3.50)	1.46 (0.82–2.57)	37	1.18 (0.55–2.57)	0.96 (0.39–2.37)
Moderate	19	53	1.79 (1.08–2.96)	0.90 (0.46–1.77)	42	1.61 (0.83–3.10)	0.71 (0.26–1.96)
Severe	8	50	2.06 (1.01–4.21)	1.23 (0.55–2.73)	50	1.80 (0.73–4.44)	1.08 (0.37–3.13)
1989–1998
No	302	32	1	1	23	1	1
Mild	31	48	2.24 (1.48–3.39)	1.71 (1.10–2.66)	26	1.49 (0.79–2.78)	1.85 (0.94–3.63)
Moderate	33	76	4.02 (2.73–5.91)	1.64 (1.04–2.59)	42	3.03 (1.77–5.18)	1.77 (0.93–3.37)
Severe	24	63	2.46 (1.56–3.88)	2.01 (1.21–3.32)	42	1.84 (0.95–3.53)	2.53 (1.17–5.48)
1999–2008
No	387	35	1	1	27	1	1
Mild	56	48	1.59 (1.08–2.34)	1.58 (1.04–2.40)	36	1.41 (0.87–2.27)	1.59 (0.94–2.68)
Moderate	55	56	2.15 (1.51–3.05)	1.83 (1.24–2.71)	40	1.92 (1.24–2.96)	2.06 (1.26–3.38)
Severe	54	74	3.03 (2.17–4.25)	2.59 (1.73–3.87)	44	2.26 (1.46–3.49)	2.30 (1.34–3.95)

CI, confidence interval; HR, hazard ratio; N, number. *Analyses adjusted for age, sex, stage at diagnosis, tumor size, depth, grade, surgical margin, radiotherapy, and chemotherapy.