Article Text

Download PDFPDF
Type I Versus Type II Endometrial Cancer: Differential Impact of Comorbidity
  1. Mette Calundann Noer, MD*,
  2. Sofie Leisby Antonsen, PhD, MD*,
  3. Bent Ottesen, DMSc, MD*,
  4. Ib Jarle Christensen, MSc and
  5. Claus Høgdall, DMSc, MD*
  1. * Department of Gynecology, Juliane Marie Centret, Rigshospitalet, Copenhagen; and
  2. Department of Pathology, Herlev University Hospital, Herlev, Denmark.
  1. Address correspondence and reprint requests to Mette Calundann Noer, MD, Department of Gynecology, Research Unit of Women and Children's Health, Juliane Marie Centret, entrance 7821, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. E-mail: mette.calundann.noer{at}


Objective Two distinct types of endometrial carcinoma (EC) with different etiology, tumor characteristics, and prognosis are recognized. We investigated if the prognostic impact of comorbidity varies between these 2 types of EC. Furthermore, we studied if the recently developed ovarian cancer comorbidity index (OCCI) is useful for prediction of survival in EC.

Materials and Methods This nationwide register-based cohort study was based on data from 6487 EC patients diagnosed in Denmark between 2005 and 2015. Patients were assigned a comorbidity index score according to the Charlson comorbidity index (CCI) and the OCCI. Kaplan-Meier survival statistics and adjusted multivariate Cox regression analyses were used to investigate the differential association between comorbidity and overall survival in types I and II EC.

Results The distribution of comorbidities varied between the 2 EC types. A consistent association between increasing levels of comorbidity and poorer survival was observed for both types. Cox regression analyses revealed a significant interaction between cancer stage and comorbidity indicating that the impact of comorbidity varied with stage. In contrast, the interaction between comorbidity and EC type was not significant. Both the CCI and the OCCI were useful measurements of comorbidity, but the CCI was the strongest predictor in this patient population.

Conclusions Comorbidity is an important prognostic factor in type I as well as in type II EC although the overall prognosis differs significantly between the 2 types of EC. The prognostic impact of comorbidity varies with stage but not with type of EC.

  • Comorbidity
  • Multimorbidity
  • Endometrial carcinoma
  • Prognosis
  • Survival

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • The authors declare no conflicts of interest.