(S033) Predictive Capacity of Three Comorbidity Indices in Estimating Survival Endpoints in Women With Early-Stage Endometrial Carcinoma

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OncologyOncology Vol 29 No 4_Suppl_1
Volume 29
Issue 4_Suppl_1

While all three comorbidity indices correlated significantly with OS in women with early-stage EC, AACCI was the only independent predictor of OS and should be considered for evaluating comorbidity in future endometrial cancer patients.

Sean Vance, MD, Meredith Mahan, Mohamed Elshaikh, MD; Henry Ford Hospital

PURPOSE/OBJECTIVES: The negative impact of medical comorbidity on survival endpoints in women with endometrial carcinoma (EC) is well known. Few validated comorbidity indices are available for clinical use-eg, the Charlson Comorbidity Index (CCI), age-adjusted Charlson Comorbidity Index (AACCI), and Adult Comorbidity Evaluation-27 (ACE-27). The study goal is to evaluate which index correlates best with survival endpoints in women with early-stage EC.

MATERIALS AND METHODS: For this institutional review board (IRB)-approved study, our prospectively maintained database of 1,920 women with endometrial cancer was reviewed. We identified 1,132 women with endometrioid carcinoma International Federation of Gynecology and Obstetrics (FIGO) stages I–II who underwent hysterectomy from 1987–2011. The three comorbidity indices at the time of hysterectomy were retrospectively calculated by physician chart review. Univariate and multivariate modeling with Cox regression analysis was used to determine the significant predictors of survival endpoints. Kaplan-Meier and log-rank test methods were used to evaluate survival outcomes.

RESULTS: After a median follow-up of 60 months, 262 deaths were recorded (42 from EC [16%] and 220 [84%] from other causes). For each of the studied comorbidity indices, the highest scores correlated significantly with poorer overall survival (OS). The hazard ratio of death from any cause was 3.92 (95% confidence interval [CI], 2.95–5.20) for AACCI, 2.25 (95% CI, 1.73–2.94) for CCI, and 1.57 (95% CI, 1.23–2.01) for ACE-27. Lymphovascular space involvement, tumor grade, lower uterine segment involvement, and AACCI were independent predictors of OS. None of the three comorbidity indices was significantly predictive of disease-specific or recurrence-free survival.

CONCLUSIONS: While all three comorbidity indices correlated significantly with OS in women with early-stage EC, AACCI was the only independent predictor of OS and should be considered for evaluating comorbidity in future endometrial cancer patients. 

Proceedings of the 97th Annual Meeting of the American Radium Society- americanradiumsociety.org

Articles in this issue

(P005) Ultrasensitive PSA Identifies Patients With Organ-Confined Prostate Cancer Requiring Postop Radiotherapy
(P001) Disparities in the Local Management of Breast Cancer in the United States According to Health Insurance Status
(P002) Predictors of CNS Disease in Metastatic Melanoma: Desmoplastic Subtype Associated With Higher Risk
(P003) Identification of Somatic Mutations Using Fine Needle Aspiration: Correlation With Clinical Outcomes in Patients With Locally Advanced Pancreatic Cancer
(P004) A Retrospective Study to Assess Disparities in the Utilization of Intensity-Modulated Radiotherapy (IMRT) and Proton Therapy (PT) in the Treatment of Prostate Cancer (PCa)
(S001) Tumor Control and Toxicity Outcomes for Head and Neck Cancer Patients Re-Treated With Intensity-Modulated Radiation Therapy (IMRT)-A Fifteen-Year Experience
(S003) Weekly IGRT Volumetric Response Analysis as a Predictive Tool for Locoregional Control in Head and Neck Cancer Radiotherapy 
(S004) Combination of Radiotherapy and Cetuximab for Aggressive, High-Risk Cutaneous Squamous Cell Cancer of the Head and Neck: A Propensity Score Analysis
(S005) Radiotherapy for Carcinoma of the Hypopharynx Over Five Decades: Experience at a Single Institution
(S002) Prognostic Value of Intraradiation Treatment FDG-PET Parameters in Locally Advanced Oropharyngeal Cancer
(P006) The Role of Sequential Imaging in Cervical Cancer Management
(P008) Pretreatment FDG Uptake of Nontarget Lung Tissue Correlates With Symptomatic Pneumonitis Following Stereotactic Ablative Radiotherapy (SABR)
(P009) Monte Carlo Dosimetry Evaluation of Lung Stereotactic Body Radiosurgery
(P010) Stereotactic Body Radiotherapy for Treatment of Adrenal Gland Metastasis: Toxicity, Outcomes, and Patterns of Failure
(P011) Stereotactic Radiosurgery and BRAF Inhibitor Therapy for Melanoma Brain Metastases Is Associated With Increased Risk for Radiation Necrosis
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