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@ARTICLE{Boakye:132629,
      author       = {D. Boakye$^*$ and B. Rillmann$^*$ and V. Walter$^*$ and L.
                      Jansen$^*$ and M. Hoffmeister$^*$ and H. Brenner$^*$},
      title        = {{I}mpact of comorbidity and frailty on prognosis in
                      colorectal cancer patients: {A} systematic review and
                      meta-analysis.},
      journal      = {Cancer treatment reviews},
      volume       = {64},
      issn         = {0305-7372},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2018-00289},
      pages        = {30 - 39},
      year         = {2018},
      abstract     = {Colorectal cancer (CRC) is largely diagnosed at old age,
                      when comorbidities and frailty are common and might be
                      important prognostic factors of CRC. We aimed to
                      systematically review epidemiological evidence on the
                      prognostic role of comorbidity and frailty in CRC
                      patients.We systematically searched the PubMed and Web of
                      Science databases up to August 08, 2017 for observational
                      studies that used a standardized index to assess comorbidity
                      or frailty, investigated and reported odds ratios (OR) or
                      hazard ratios (HR) of their associations with any of the
                      following CRC prognostic outcomes: thirty-day, overall or
                      CRC-specific mortality and disease-free or recurrence-free
                      survival. The study was conducted using standard
                      meta-analysis methodology.Thirty-seven cohort studies were
                      identified and included in this review: 35 on comorbidity
                      and 2 on frailty. Of the 35 studies, 13 with comparable
                      methodology were eligible for a meta-analysis. Compared to
                      CRC patients without comorbidity, those with mild/moderate
                      and severe comorbidity had, respectively, a higher risk of
                      30-day (OR = 1.71; $95\%$ confidence interval (CI):
                      1.26-2.31 and OR = 2.62; $95\%$ CI: 1.97-3.47), overall
                      (HR = 1.41; $95\%$ CI: 1.23-1.62 and HR = 2.03;
                      $95\%$ CI: 1.76-2.34), and CRC-specific mortality
                      (HR = 1.06; $95\%$ CI: 1.02-1.10 and HR = 1.14;
                      $95\%$ CI: 1.04-1.23). Frail CRC patients showed higher
                      overall mortality than non-frail patients (HRrange:
                      2.60-3.39).Comorbidity and frailty are strong prognostic
                      factors of survival in CRC patients apart from the commonly
                      considered sociodemographic and tumor characteristics.
                      Comprehensive geriatric assessment might help to optimize
                      care of CRC patients, by improving early identification and
                      management of comorbidities and geriatric syndromes.},
      subtyp        = {Review Article},
      cin          = {C070 / G110 / L101},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)G110-20160331 /
                      I:(DE-He78)L101-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29459248},
      doi          = {10.1016/j.ctrv.2018.02.003},
      url          = {https://inrepo02.dkfz.de/record/132629},
}