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- Title
Does Age-Adjusted Charlson Comorbidity Score Impact Survival Endpoints in Women with Federation of Gynecology and Obstetrics-Stage III Endometrial Cancer?
- Authors
Ghanem, Ahmed I.; Modh, Ankit; Burmeister, Charlotte; Munkarah, Adnan R.; Elshaikh, Mohamed A.; Ghanem, Ahmed I; Munkarah, Adnan R; Elshaikh, Mohamed A
- Abstract
<bold>Objectives: </bold>We sought to evaluate the impact of age-adjusted Charlson comorbidity index (AACCI) score on survival endpoints for women with advanced stage endometrial carcinoma (EC).<bold>Methods and Materials: </bold>We identified 238 women with stage III EC. AACCI score was calculated and 3 groups were created accordingly; group 1 with a score of 0-2, group 2 with score 3-4, and group 3 with score ≥5. Significant predictors of recurrence-free (RFS), disease-specific (DSS) and overall survival (OS) were analyzed.<bold>Results: </bold>Median follow-up was 54 months and median age was 65 years. Stage IIIC was the most common stage (69%). The 3 groups were well-balanced except for less utilization of adjuvant chemotherapy in group 3 (p = 0.01). Five-year OS was significantly lower in group 3 compared to groups 1 and 2 (23 vs. 65 and 51%, respectively). Similarly, 5-year RFS was 54, 41, and 33% and DSS was 65, 54, and 35% for groups 1, 2, and 3 respectively. On multivariate analyses, AACCI group 3, cervical stromal involvement, positive peritoneal cytology, and higher tumor grade were predictors for shorter OS. Cervical stromal involvement and higher grade were independent predictors for worse RFS and DSS. Additionally, positive cytology, lymphovascular space invasion, and stage IIIC2 were significantly detrimental for RFS.<bold>Conclusions: </bold>Our study suggests that comorbidity burden is a strong predictor of worse OS in women with stage III EC. Women with higher AACCI are less likely to receive adjuvant chemotherapy. Comorbidity score can significantly impact survival endpoints for women with advanced EC.
- Subjects
ENDOMETRIAL cancer; CANCER in women; CANCER chemotherapy; ADJUVANT treatment of cancer; COMORBIDITY; PATIENTS; AGE distribution; CANCER relapse; LONGITUDINAL method; MULTIVARIATE analysis; SURVIVAL; TUMOR classification; ENDOMETRIAL tumors; RETROSPECTIVE studies; SEVERITY of illness index
- Publication
Gynecologic & Obstetric Investigation, 2018, Vol 83, Issue 3, p290
- ISSN
0378-7346
- Publication type
journal article
- DOI
10.1159/000487047