Comorbidity is an independent prognostic factor in women with uterine corpus cancer: a nationwide cohort study

TY - JOUR

T1 - Comorbidity is an independent prognostic factor in women with uterine corpus cancer

T2 - a nationwide cohort study

AU - Noer, Mette C

AU - Sperling, Cecilie

AU - Christensen, Ib J

AU - Nielsen, Marie L S

AU - Lidegaard, Ojvind

AU - Høgdall, Claus

N1 - © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

PY - 2014/4

Y1 - 2014/4

N2 - Objective To determine whether comorbidity independently affects overall survival in women with uterine corpus cancer. Design Cohort study. Setting Denmark. Study population A total of 4244 patients registered in the Danish Gynecologic Cancer database with uterine corpus cancer from 1 January 2005 until 13 October 2011. Methods All patients included in the study were assigned a comorbidity score according to the Charlson Comorbidity Index. Multivariate survival analyses were performed to investigate the prognostic impact of comorbidity adjusting for known prognostic factors. As performance status might capture the prognostic impact of comorbidity and because information on the variable grade was missing in some special histological subtypes, we included different models in the multivariate analyses with and without PS and grade, respectively. Main outcome measures Overall survival. Results Univariate survival analysis showed a significant (p < 0.001) negative association between increasing level of comorbidity and overall survival. Multivariate analyses adjusting for other prognostic factors showed that comorbidity is a significant independent prognostic factor with hazard ratios ranging from 1.27 to 1.42 in mild, 1.69 to 1.74 in moderate, and 1.72 to 2.48 in severe comorbidity. Performance status was independently associated to overall survival and was found to slightly reduce the prognostic impact of comorbidity. Conclusion Comorbidity is an independent prognostic factor in uterine corpus cancer and increasing levels of comorbidity are associated with shorter survival.

AB - Objective To determine whether comorbidity independently affects overall survival in women with uterine corpus cancer. Design Cohort study. Setting Denmark. Study population A total of 4244 patients registered in the Danish Gynecologic Cancer database with uterine corpus cancer from 1 January 2005 until 13 October 2011. Methods All patients included in the study were assigned a comorbidity score according to the Charlson Comorbidity Index. Multivariate survival analyses were performed to investigate the prognostic impact of comorbidity adjusting for known prognostic factors. As performance status might capture the prognostic impact of comorbidity and because information on the variable grade was missing in some special histological subtypes, we included different models in the multivariate analyses with and without PS and grade, respectively. Main outcome measures Overall survival. Results Univariate survival analysis showed a significant (p < 0.001) negative association between increasing level of comorbidity and overall survival. Multivariate analyses adjusting for other prognostic factors showed that comorbidity is a significant independent prognostic factor with hazard ratios ranging from 1.27 to 1.42 in mild, 1.69 to 1.74 in moderate, and 1.72 to 2.48 in severe comorbidity. Performance status was independently associated to overall survival and was found to slightly reduce the prognostic impact of comorbidity. Conclusion Comorbidity is an independent prognostic factor in uterine corpus cancer and increasing levels of comorbidity are associated with shorter survival.

KW - Adenocarcinoma

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Carcinoma

KW - Cohort Studies

KW - Comorbidity

KW - Denmark

KW - Female

KW - Humans

KW - Kaplan-Meier Estimate

KW - Middle Aged

KW - Neoplasm Grading

KW - Neoplasm Staging

KW - Neoplasm, Residual

KW - Predictive Value of Tests

KW - Prognosis

KW - Risk Factors

KW - Sarcoma

KW - Uterine Neoplasms

U2 - 10.1111/aogs.12338

DO - 10.1111/aogs.12338

M3 - Journal article

C2 - 24443826

SN - 0001-6349

VL - 93

SP - 325

EP - 334

JO - Acta Obstetrica et Gynecologica

JF - Acta Obstetrica et Gynecologica

IS - 4

ER -