The relationship of comorbidities to mortality and cause of death in patients with differentiated thyroid carcinoma

Young Ki Lee, Namki Hong, Se Hee Park, Dong Yeob Shin, Cho Rok Lee, Sang Wook Kang, Jandee Lee, Jong Ju Jeong, Kee Hyun Nam, Woong Youn Chung, Eun Jig Lee

Research output: Contribution to journalArticle

Abstract

Understanding how comorbidities contribute to death in cancer patients is becoming an important topic. The present study assessed the role of comorbidities in overall mortality and causes of death in patients with differentiated thyroid carcinoma (DTC). This retrospective cohort study included 2070 patients who underwent thyroidectomy for DTC at a single institution between 2002 and 2005. Probabilities of overall, DTC-specific and other-cause death were examined according to the number of comorbidities, with consideration for competing events. The estimated 15-year cumulative incidences of overall, DTC-specific, and other-cause death were 7.3%, 1.6%, and 5.7%, respectively. Taking the group without comorbidities as a reference, we found that the group with 1–2 comorbidities and the group with ≥3 comorbidities had higher probabilities of other-cause death (subhazard ratios = 2.48 and 9.41, respectively; p < 0.01) and consequently shorter overall survival (hazard ratio = 1.95 and 5.33, respectively; p < 0.01), with adjustment for age, sex, and tumor-node-metastasis classification. In contrast, the probability of DTC-specific death was reduced in patients with ≥3 comorbidities (subhazard ratio = 6.81e-10, p < 0.01). For overall death, the relative proportion of death from DTC reduced when the number of comorbidities increased, and DTC-specific death was not observed in patients with ≥3 comorbidities. Our results show that death from DTC itself accounted for only a fraction of the overall deaths among patients who underwent surgery for DTC. Comorbidities increased overall mortality by increasing the probability of other-cause death. Patients with multiple comorbidities had a low probability of dying from DTC because they died earlier from comorbidities.

Original languageEnglish
Article number11435
JournalScientific reports
Volume9
Issue number1
DOIs
Publication statusPublished - 2019 Dec 1

Fingerprint

Thyroid Neoplasms
Comorbidity
Cause of Death
Mortality
Thyroidectomy
Neoplasms
Cohort Studies
Retrospective Studies
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • General

Cite this

Lee, Young Ki ; Hong, Namki ; Park, Se Hee ; Shin, Dong Yeob ; Lee, Cho Rok ; Kang, Sang Wook ; Lee, Jandee ; Jeong, Jong Ju ; Nam, Kee Hyun ; Chung, Woong Youn ; Lee, Eun Jig. / The relationship of comorbidities to mortality and cause of death in patients with differentiated thyroid carcinoma. In: Scientific reports. 2019 ; Vol. 9, No. 1.
@article{435f6f275e614ffaa2bcabedb759f08b,
title = "The relationship of comorbidities to mortality and cause of death in patients with differentiated thyroid carcinoma",
abstract = "Understanding how comorbidities contribute to death in cancer patients is becoming an important topic. The present study assessed the role of comorbidities in overall mortality and causes of death in patients with differentiated thyroid carcinoma (DTC). This retrospective cohort study included 2070 patients who underwent thyroidectomy for DTC at a single institution between 2002 and 2005. Probabilities of overall, DTC-specific and other-cause death were examined according to the number of comorbidities, with consideration for competing events. The estimated 15-year cumulative incidences of overall, DTC-specific, and other-cause death were 7.3{\%}, 1.6{\%}, and 5.7{\%}, respectively. Taking the group without comorbidities as a reference, we found that the group with 1–2 comorbidities and the group with ≥3 comorbidities had higher probabilities of other-cause death (subhazard ratios = 2.48 and 9.41, respectively; p < 0.01) and consequently shorter overall survival (hazard ratio = 1.95 and 5.33, respectively; p < 0.01), with adjustment for age, sex, and tumor-node-metastasis classification. In contrast, the probability of DTC-specific death was reduced in patients with ≥3 comorbidities (subhazard ratio = 6.81e-10, p < 0.01). For overall death, the relative proportion of death from DTC reduced when the number of comorbidities increased, and DTC-specific death was not observed in patients with ≥3 comorbidities. Our results show that death from DTC itself accounted for only a fraction of the overall deaths among patients who underwent surgery for DTC. Comorbidities increased overall mortality by increasing the probability of other-cause death. Patients with multiple comorbidities had a low probability of dying from DTC because they died earlier from comorbidities.",
author = "Lee, {Young Ki} and Namki Hong and Park, {Se Hee} and Shin, {Dong Yeob} and Lee, {Cho Rok} and Kang, {Sang Wook} and Jandee Lee and Jeong, {Jong Ju} and Nam, {Kee Hyun} and Chung, {Woong Youn} and Lee, {Eun Jig}",
year = "2019",
month = "12",
day = "1",
doi = "10.1038/s41598-019-47898-8",
language = "English",
volume = "9",
journal = "Scientific Reports",
issn = "2045-2322",
publisher = "Nature Publishing Group",
number = "1",

}

Lee, YK, Hong, N, Park, SH, Shin, DY, Lee, CR, Kang, SW, Lee, J, Jeong, JJ, Nam, KH, Chung, WY & Lee, EJ 2019, 'The relationship of comorbidities to mortality and cause of death in patients with differentiated thyroid carcinoma', Scientific reports, vol. 9, no. 1, 11435. https://doi.org/10.1038/s41598-019-47898-8

The relationship of comorbidities to mortality and cause of death in patients with differentiated thyroid carcinoma. / Lee, Young Ki; Hong, Namki; Park, Se Hee; Shin, Dong Yeob; Lee, Cho Rok; Kang, Sang Wook; Lee, Jandee; Jeong, Jong Ju; Nam, Kee Hyun; Chung, Woong Youn; Lee, Eun Jig.

In: Scientific reports, Vol. 9, No. 1, 11435, 01.12.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The relationship of comorbidities to mortality and cause of death in patients with differentiated thyroid carcinoma

AU - Lee, Young Ki

AU - Hong, Namki

AU - Park, Se Hee

AU - Shin, Dong Yeob

AU - Lee, Cho Rok

AU - Kang, Sang Wook

AU - Lee, Jandee

AU - Jeong, Jong Ju

AU - Nam, Kee Hyun

AU - Chung, Woong Youn

AU - Lee, Eun Jig

PY - 2019/12/1

Y1 - 2019/12/1

N2 - Understanding how comorbidities contribute to death in cancer patients is becoming an important topic. The present study assessed the role of comorbidities in overall mortality and causes of death in patients with differentiated thyroid carcinoma (DTC). This retrospective cohort study included 2070 patients who underwent thyroidectomy for DTC at a single institution between 2002 and 2005. Probabilities of overall, DTC-specific and other-cause death were examined according to the number of comorbidities, with consideration for competing events. The estimated 15-year cumulative incidences of overall, DTC-specific, and other-cause death were 7.3%, 1.6%, and 5.7%, respectively. Taking the group without comorbidities as a reference, we found that the group with 1–2 comorbidities and the group with ≥3 comorbidities had higher probabilities of other-cause death (subhazard ratios = 2.48 and 9.41, respectively; p < 0.01) and consequently shorter overall survival (hazard ratio = 1.95 and 5.33, respectively; p < 0.01), with adjustment for age, sex, and tumor-node-metastasis classification. In contrast, the probability of DTC-specific death was reduced in patients with ≥3 comorbidities (subhazard ratio = 6.81e-10, p < 0.01). For overall death, the relative proportion of death from DTC reduced when the number of comorbidities increased, and DTC-specific death was not observed in patients with ≥3 comorbidities. Our results show that death from DTC itself accounted for only a fraction of the overall deaths among patients who underwent surgery for DTC. Comorbidities increased overall mortality by increasing the probability of other-cause death. Patients with multiple comorbidities had a low probability of dying from DTC because they died earlier from comorbidities.

AB - Understanding how comorbidities contribute to death in cancer patients is becoming an important topic. The present study assessed the role of comorbidities in overall mortality and causes of death in patients with differentiated thyroid carcinoma (DTC). This retrospective cohort study included 2070 patients who underwent thyroidectomy for DTC at a single institution between 2002 and 2005. Probabilities of overall, DTC-specific and other-cause death were examined according to the number of comorbidities, with consideration for competing events. The estimated 15-year cumulative incidences of overall, DTC-specific, and other-cause death were 7.3%, 1.6%, and 5.7%, respectively. Taking the group without comorbidities as a reference, we found that the group with 1–2 comorbidities and the group with ≥3 comorbidities had higher probabilities of other-cause death (subhazard ratios = 2.48 and 9.41, respectively; p < 0.01) and consequently shorter overall survival (hazard ratio = 1.95 and 5.33, respectively; p < 0.01), with adjustment for age, sex, and tumor-node-metastasis classification. In contrast, the probability of DTC-specific death was reduced in patients with ≥3 comorbidities (subhazard ratio = 6.81e-10, p < 0.01). For overall death, the relative proportion of death from DTC reduced when the number of comorbidities increased, and DTC-specific death was not observed in patients with ≥3 comorbidities. Our results show that death from DTC itself accounted for only a fraction of the overall deaths among patients who underwent surgery for DTC. Comorbidities increased overall mortality by increasing the probability of other-cause death. Patients with multiple comorbidities had a low probability of dying from DTC because they died earlier from comorbidities.

UR - http://www.scopus.com/inward/record.url?scp=85070402873&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070402873&partnerID=8YFLogxK

U2 - 10.1038/s41598-019-47898-8

DO - 10.1038/s41598-019-47898-8

M3 - Article

C2 - 31391492

AN - SCOPUS:85070402873

VL - 9

JO - Scientific Reports

JF - Scientific Reports

SN - 2045-2322

IS - 1

M1 - 11435

ER -