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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.
- Source :
-
Gynecologic oncology [Gynecol Oncol] 2015 Aug; Vol. 138 (2), pp. 246-51. Date of Electronic Publication: 2015 May 31. - Publication Year :
- 2015
-
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).<br />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.<br />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).<br />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.<br /> (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Age Factors
Carcinoma, Ovarian Epithelial
Disease-Free Survival
Fallopian Tube Neoplasms pathology
Fallopian Tube Neoplasms surgery
Female
Humans
Middle Aged
Morbidity
Neoplasm Staging
Perioperative Period
Peritoneal Neoplasms pathology
Peritoneal Neoplasms surgery
Postoperative Complications etiology
Predictive Value of Tests
Retrospective Studies
Survival Rate
Young Adult
Gynecologic Surgical Procedures adverse effects
Gynecologic Surgical Procedures methods
Neoplasms, Glandular and Epithelial pathology
Neoplasms, Glandular and Epithelial surgery
Ovarian Neoplasms pathology
Ovarian Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1095-6859
- Volume :
- 138
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Gynecologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 26037900
- Full Text :
- https://doi.org/10.1016/j.ygyno.2015.05.034