The age-adjusted Charlson comorbidity index as a predictor of survival in surgically treated vulvar cancer patients.
- Author:
Violante DI DONATO
1
;
Zoe PAGE
;
Carlotta BRACCHI
;
Federica TOMAO
;
Angela MUSELLA
;
Giorgia PERNIOLA
;
Pierluigi Benedetti PANICI
Author Information
- Publication Type:Original Article
- Keywords: Vulvar Cancer; Comorbidity; Prognostic Factors; Elderly; Frailty
- MeSH: Aged; Comorbidity*; Disease-Free Survival; Humans; Logistic Models; Multicenter Studies as Topic; Multivariate Analysis; Prognosis; Proportional Hazards Models; Prospective Studies; Recurrence; Retrospective Studies; Vulvar Neoplasms*
- From:Journal of Gynecologic Oncology 2019;30(1):e6-
- CountryRepublic of Korea
- Language:English
- Abstract: 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.
