TY - JOUR
T1 - 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
AU - Suidan, Rudy S.
AU - Leitao, Mario M.
AU - Zivanovic, Oliver
AU - Gardner, Ginger J.
AU - Long Roche, Kara C.
AU - Sonoda, Yukio
AU - Levine, Douglas A.
AU - Jewell, Elizabeth L.
AU - Brown, Carol L.
AU - Abu-Rustum, Nadeem R.
AU - Charlson, Mary E.
AU - Chi, Dennis S.
N1 - Funding Information:
This study was supported by the Roy M. Speer Foundation .
Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - 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.
AB - 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.
KW - Age-Adjusted Charlson Comorbidity Index
KW - Ovarian cancer
KW - Overall survival
KW - Perioperative complications
KW - Progression-free survival
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U2 - 10.1016/j.ygyno.2015.05.034
DO - 10.1016/j.ygyno.2015.05.034
M3 - Article
C2 - 26037900
AN - SCOPUS:84938214952
SN - 0090-8258
VL - 138
SP - 246
EP - 251
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 2
ER -