Title |
Prognostic Value of the Age-Adjusted Charlson Comorbidity Index (ACCI) on Short- and Long-Term Outcome in Patients with Advanced Primary Epithelial Ovarian Cancer
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Published in |
Annals of Surgical Oncology, September 2017
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DOI | 10.1245/s10434-017-6079-9 |
Pubmed ID | |
Authors |
Annett Kahl, Andreas du Bois, Philipp Harter, Sonia Prader, Stephanie Schneider, Florian Heitz, Alexander Traut, Pier Francesco Alesina, Beate Meier, Martin Walz, Annettte Brueckner, Harald-Thomas Groeben, Violeta Brunkhorst, Sebastian Heikaus, Beyhan Ataseven |
Abstract |
We evaluated the prognostic impact of the age-adjusted Charlson Comorbidity Index (ACCI) on both postoperative morbidity and overall survival (OS) in patients with advanced epithelial ovarian cancer (EOC) treated at a tertiary gynecologic cancer center. Exploratory analysis of our prospectively documented tumor registry was performed. Data of all consecutive patients with stage IIIB-IV ovarian cancer who underwent primary cytoreductive surgery (PDS) from January 2000 to June 2016 were analyzed. Patients were divided into three groups, based on their ACCI: low (0-1), intermediate (2-3), and high (≥4), and postoperative surgical complications were graded according to the Clavien-Dindo classification (CDC). The Fisher's exact test, log-rank test, and Cox regression models were used to investigate the predictive value of the ACCI on postoperative complications and OS. Overall, 793 consecutive patients were identified; 328 (41.4%) patients were categorized as low ACCI, 342 (43.1%) as intermediate ACCI, and 123 (15.5%) as high ACCI. A high ACCI was significantly associated with severe postoperative complications (CDC 3-5; odds ratio 3.27, 95% confidence interval 1.97-5.43, p < 0.001). Median OS for patients with a low, intermediate, or high ACCI was 50, 40, and 23 months, respectively (p < 0.001), and the ACCI remained a significant prognostic factor for OS in multivariate analysis (p = 0.001). The same impact was observed in a sensitivity analysis including only those patients with complete tumor resection. The ACCI is associated with perioperative morbidity in patients undergoing PDS for EOC, and also has a prognostic impact on OS. The potential role of the ACCI as a selection criteria for different therapy strategies is currently under investigation in the ongoing, prospective, multicenter AGO-OVAR 19 trial. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 35 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 6 | 17% |
Student > Bachelor | 5 | 14% |
Other | 3 | 9% |
Professor | 3 | 9% |
Student > Postgraduate | 3 | 9% |
Other | 4 | 11% |
Unknown | 11 | 31% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 14 | 40% |
Biochemistry, Genetics and Molecular Biology | 3 | 9% |
Business, Management and Accounting | 1 | 3% |
Physics and Astronomy | 1 | 3% |
Psychology | 1 | 3% |
Other | 0 | 0% |
Unknown | 15 | 43% |