Read at al evaluated the significance of comorbidity when evaluating a patient with cancer. Sometimes comorbidity is significant and sometimes it is not. The authors are from the University of California in San Diego and Washington University.
Patient selection: presence of cancer
Cancer Status
Significance of Comorbidity on Overall Survival
advanced stage
low
active but not advanced stage
intermediate
in remission or indolent
high
Active or Aggressive Cancer
Likelihood of Aggressive Management
low comorbidity
high
intermediate comorbidity
intermediate
high comorbidity
low
Some comorbidities may impact management and its morbidity more than others:
(1) renal dysfunction (and drug dosage adjustment)
(2) liver disease (and drug metabolism)
(3) malnutrition
(4) heart disease and therapy with cardiotoxic effects
(5) hematopoietic dysfunction
(6) immunodeficiency (and a tumor impacted by immune response)
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