Predictive value of the Age-Adjusted Charlson Comorbidity Index on perioperative complications and survival in patients undergoing primary debulking surgery for advanced epithelial ovarian cancer Journal Article
| Authors: | Suidan, R. S.; Leitao, M. M. Jr; Zivanovic, O.; Gardner, G. J.; Long Roche, K. C.; Sonoda, Y.; Levine, D. A.; Jewell, E. L.; Brown, C. L.; Abu-Rustum, N. R.; Charlson, M. E.; Chi, D. S. |
| Article Title: | Predictive value of the Age-Adjusted Charlson Comorbidity Index on perioperative complications and survival in patients undergoing primary debulking surgery for advanced epithelial ovarian cancer |
| Abstract: | Objective To assess the ability of the Age-Adjusted Charlson Comorbidity Index (ACCI) to predict perioperative complications and survival in patients undergoing primary debulking for advanced epithelial ovarian cancer (EOC). Methods Data were analyzed for all patients with stage IIIB-IV EOC who underwent primary cytoreduction from 1/2001-1/2010 at our institution. Patients were divided into 3 groups based on an ACCI of 0-1, 2-3, and ≥ 4. Clinical and survival outcomes were assessed and compared. Results We identified 567 patients; 199 (35%) had an ACCI of 0-1, 271 (48%) had an ACCI of 2-3, and 97 (17%) had an ACCI of ≥ 4. The ACCI was significantly associated with the rate of complete gross resection (0-1 = 44%, 2-3 = 32%, and ≥ 4 = 32%; p = 0.02), but was not associated with the rate of minor (47% vs 47% vs 43%, p = 0.84) or major (18% vs 19% vs 16%, p = 0.8) complications. The ACCI was also significantly associated with progression-free (PFS) and overall survival (OS). Median PFS for patients with an ACCI of 0-1, 2-3, and ≥ 4 was 20.3, 16, and 15.4 months, respectively (p = 0.02). Median OS for patients with an ACCI of 0-1, 2-3, and ≥ 4 was 65.3, 49.9, and 42.3 months, respectively (p < 0.001). On multivariate analysis, the ACCI remained a significant prognostic factor for both PFS (p = 0.02) and OS (p < 0.001). Conclusions The ACCI was not associated with perioperative complications in patients undergoing primary cytoreduction for advanced EOC, but was a significant predictor of PFS and OS. Prospective clinical trials in ovarian cancer should consider stratifying for an age-comorbidity covariate. © 2015 Elsevier Inc. All rights reserved. |
| Keywords: | adult; cancer survival; aged; major clinical study; overall survival; conference paper; cancer patient; cancer staging; outcome assessment; ovarian cancer; cytoreductive surgery; progression free survival; gastrointestinal symptom; cardiovascular disease; diabetes mellitus; ovary carcinoma; postoperative infection; connective tissue disease; wound complication; predictive value; perioperative complications; progression-free survival; lung complication; peroperative complication; age adjusted charlson comorbidity index; cancer prognosis; charlson comorbidity index; human; female; priority journal; chronic lung disease; age-adjusted charlson comorbidity index |
| Journal Title: | Gynecologic Oncology |
| Volume: | 138 |
| Issue: | 2 |
| ISSN: | 10956859 |
| Publisher: | Elsevier B.V. |
| Date Published: | 2015-08-01 |
| Start Page: | 246 |
| End Page: | 251 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2015.05.034 |
| PROVIDER: | scopus |
| PUBMED: | 26037900 |
| PMCID: | PMC4972341 |
| DOI/URL: | |
| Notes: | Export Date: 2 September 2015 -- Source: Scopus |
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