Cargando…

The age-adjusted Charlson comorbidity index as a predictor of survival in surgically treated vulvar cancer patients

OBJECTIVE: To evaluate the impact of age-adjusted Charlson comorbidity index (ACCI) in predicting disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS) among surgically treated patients with vulvar carcinoma. The secondary aim is to evaluate its impact as a predictor...

Descripción completa

Detalles Bibliográficos
Autores principales: Di Donato, Violante, Page, Zoe, Bracchi, Carlotta, Tomao, Federica, Musella, Angela, Perniola, Giorgia, Panici, Pierluigi Benedetti
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304403/
https://www.ncbi.nlm.nih.gov/pubmed/30479090
http://dx.doi.org/10.3802/jgo.2019.30.e6
_version_ 1783382352159834112
author Di Donato, Violante
Page, Zoe
Bracchi, Carlotta
Tomao, Federica
Musella, Angela
Perniola, Giorgia
Panici, Pierluigi Benedetti
author_facet Di Donato, Violante
Page, Zoe
Bracchi, Carlotta
Tomao, Federica
Musella, Angela
Perniola, Giorgia
Panici, Pierluigi Benedetti
author_sort Di Donato, Violante
collection PubMed
description OBJECTIVE: To evaluate the impact of age-adjusted Charlson comorbidity index (ACCI) in predicting disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS) among surgically treated patients with vulvar carcinoma. The secondary aim is to evaluate its impact as a predictor of the pattern of recurrence. METHODS: We retrospectively evaluated data of patients that underwent surgical treatment for vulvar cancer from 1998 to 2016. ACCI at the time of primary surgery was evaluated and patients were classified as low (ACCI 0–1), intermediate (ACCI 2–3), and high risk (>3). DFS, OS and CSS were analyzed using the Kaplan-Meir and the Cox proportional hazard models. Logistic regression model was used to assess predictors of distant and local recurrence. RESULTS: Seventy-eight patients were included in the study. Twelve were classified as low, 36 as intermediate, and 30 as high risk according to their ACCI. Using multivariate analysis, ACCI class was an independent predictor of worse DFS (hazard ratio [HR]=3.04; 95% confidence interval [CI]=1.54–5.99; p<0.001), OS (HR=5.25; 95% CI=1.63–16.89; p=0.005) and CSS (HR=3.79; 95% CI=1.13–12.78; p=0.03). Positive nodal status (odds ratio=8.46; 95% CI=2.13–33.58; p=0.002) was the only parameter correlated with distant recurrence at logistic regression. CONCLUSION: ACCI could be a useful tool in predicting prognosis in surgically treated vulvar cancer patients. Prospective multicenter trials assessing the role of ACCI in vulvar cancer patients are warranted.
format Online
Article
Text
id pubmed-6304403
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology
record_format MEDLINE/PubMed
spelling pubmed-63044032019-01-01 The age-adjusted Charlson comorbidity index as a predictor of survival in surgically treated vulvar cancer patients Di Donato, Violante Page, Zoe Bracchi, Carlotta Tomao, Federica Musella, Angela Perniola, Giorgia Panici, Pierluigi Benedetti J Gynecol Oncol Original Article OBJECTIVE: To evaluate the impact of age-adjusted Charlson comorbidity index (ACCI) in predicting disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS) among surgically treated patients with vulvar carcinoma. The secondary aim is to evaluate its impact as a predictor of the pattern of recurrence. METHODS: We retrospectively evaluated data of patients that underwent surgical treatment for vulvar cancer from 1998 to 2016. ACCI at the time of primary surgery was evaluated and patients were classified as low (ACCI 0–1), intermediate (ACCI 2–3), and high risk (>3). DFS, OS and CSS were analyzed using the Kaplan-Meir and the Cox proportional hazard models. Logistic regression model was used to assess predictors of distant and local recurrence. RESULTS: Seventy-eight patients were included in the study. Twelve were classified as low, 36 as intermediate, and 30 as high risk according to their ACCI. Using multivariate analysis, ACCI class was an independent predictor of worse DFS (hazard ratio [HR]=3.04; 95% confidence interval [CI]=1.54–5.99; p<0.001), OS (HR=5.25; 95% CI=1.63–16.89; p=0.005) and CSS (HR=3.79; 95% CI=1.13–12.78; p=0.03). Positive nodal status (odds ratio=8.46; 95% CI=2.13–33.58; p=0.002) was the only parameter correlated with distant recurrence at logistic regression. CONCLUSION: ACCI could be a useful tool in predicting prognosis in surgically treated vulvar cancer patients. Prospective multicenter trials assessing the role of ACCI in vulvar cancer patients are warranted. Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology 2018-10-04 /pmc/articles/PMC6304403/ /pubmed/30479090 http://dx.doi.org/10.3802/jgo.2019.30.e6 Text en Copyright © 2019. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Di Donato, Violante
Page, Zoe
Bracchi, Carlotta
Tomao, Federica
Musella, Angela
Perniola, Giorgia
Panici, Pierluigi Benedetti
The age-adjusted Charlson comorbidity index as a predictor of survival in surgically treated vulvar cancer patients
title The age-adjusted Charlson comorbidity index as a predictor of survival in surgically treated vulvar cancer patients
title_full The age-adjusted Charlson comorbidity index as a predictor of survival in surgically treated vulvar cancer patients
title_fullStr The age-adjusted Charlson comorbidity index as a predictor of survival in surgically treated vulvar cancer patients
title_full_unstemmed The age-adjusted Charlson comorbidity index as a predictor of survival in surgically treated vulvar cancer patients
title_short The age-adjusted Charlson comorbidity index as a predictor of survival in surgically treated vulvar cancer patients
title_sort age-adjusted charlson comorbidity index as a predictor of survival in surgically treated vulvar cancer patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304403/
https://www.ncbi.nlm.nih.gov/pubmed/30479090
http://dx.doi.org/10.3802/jgo.2019.30.e6
work_keys_str_mv AT didonatoviolante theageadjustedcharlsoncomorbidityindexasapredictorofsurvivalinsurgicallytreatedvulvarcancerpatients
AT pagezoe theageadjustedcharlsoncomorbidityindexasapredictorofsurvivalinsurgicallytreatedvulvarcancerpatients
AT bracchicarlotta theageadjustedcharlsoncomorbidityindexasapredictorofsurvivalinsurgicallytreatedvulvarcancerpatients
AT tomaofederica theageadjustedcharlsoncomorbidityindexasapredictorofsurvivalinsurgicallytreatedvulvarcancerpatients
AT musellaangela theageadjustedcharlsoncomorbidityindexasapredictorofsurvivalinsurgicallytreatedvulvarcancerpatients
AT perniolagiorgia theageadjustedcharlsoncomorbidityindexasapredictorofsurvivalinsurgicallytreatedvulvarcancerpatients
AT panicipierluigibenedetti theageadjustedcharlsoncomorbidityindexasapredictorofsurvivalinsurgicallytreatedvulvarcancerpatients
AT didonatoviolante ageadjustedcharlsoncomorbidityindexasapredictorofsurvivalinsurgicallytreatedvulvarcancerpatients
AT pagezoe ageadjustedcharlsoncomorbidityindexasapredictorofsurvivalinsurgicallytreatedvulvarcancerpatients
AT bracchicarlotta ageadjustedcharlsoncomorbidityindexasapredictorofsurvivalinsurgicallytreatedvulvarcancerpatients
AT tomaofederica ageadjustedcharlsoncomorbidityindexasapredictorofsurvivalinsurgicallytreatedvulvarcancerpatients
AT musellaangela ageadjustedcharlsoncomorbidityindexasapredictorofsurvivalinsurgicallytreatedvulvarcancerpatients
AT perniolagiorgia ageadjustedcharlsoncomorbidityindexasapredictorofsurvivalinsurgicallytreatedvulvarcancerpatients
AT panicipierluigibenedetti ageadjustedcharlsoncomorbidityindexasapredictorofsurvivalinsurgicallytreatedvulvarcancerpatients