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Sarcoma
Volume 2014 (2014), Article ID 690316, 9 pages
http://dx.doi.org/10.1155/2014/690316
Research Article

Comorbidity in Adult Bone Sarcoma Patients: A Population-Based Cohort Study

1Sarcoma Centre of Aarhus University Hospital, Norrebrogade 44, 8000 Aarhus, Denmark
2Department of Experimental Clinical Oncology, Aarhus University Hospital, Norrebrogade 44, Building 5, 8000 Aarhus, Denmark
3Department of Oncology, Aarhus University Hospital, Norrebrogade 44, Building 5, 8000 Aarhus, Denmark
4Department of Orthopedic Surgery E5, Aarhus University Hospital, Norrebrogade 44, Building 7, 8000 Aarhus, Denmark
5Department of Pathology, Aarhus University Hospital, Norrebrogade 44, Building 18, 8000 Aarhus, Denmark

Received 3 December 2013; Revised 28 January 2014; Accepted 28 January 2014; Published 27 February 2014

Academic Editor: Clement Trovik

Copyright © 2014 Ninna Aggerholm-Pedersen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Comorbidity is an important prognostic factor for survival in different cancers; however, neither the prevalence nor the impact of comorbidity has been investigated in bone sarcoma. Methods. All adult bone sarcoma patients from western Denmark treated at the Aarhus Sarcoma Centre in the period from 1979 to 2008 were identified through a validated population-based database. Charlson Comorbidity Index scores were computed, using discharge diagnoses from the Danish National Patient Registry. Survival was assessed as overall and disease-specific mortality. The impact of comorbidity was examined as rates according to the level of comorbidity as well as uni- and multivariately using proportional hazard models. Results. A total of 453 patients were identified. The overall prevalence of comorbidity was 19%. The prevalence increased with age and over the study period. In patients with Ewing/osteosarcoma, comorbidity was not associated with an increased overall or disease-specific mortality. However, patients with bone sarcomas other than Ewing/osteosarcoma had increased overall mortality. Independent prognostic factors for disease-specific survival were age, tumor size, stage at diagnosis, soft tissue involvement, grade, and surgery. Conclusion. The prevalence of comorbidity in bone sarcoma patients is low. Comorbidity impaired survival in patients with non-Ewing/nonosteosarcoma, histology. This emphasizes the importance of not only treating the sarcoma but also comorbidity.