Introduction/Background The study goal is to utilize a validated comorbidity scoring to determine its impact on recurrence-free (RFS), disease-specific (DSS) and overall survival (OS) in women with early-stage uterine endometrioid carcinoma (EC).
Methodology We identified 1915 patients with EC stages I-II who underwent hysterectomy. Charlson Comorbidity Index (CCI) at time of hysterectomy was calculated by trained physician. Survival endpoints was correlated with CCI. Univariate and multivariate modeling with Cox regression analysis was used to determine significant predictors of OS, DSS, and RFS.
Results After a median follow-up of 104 months, 529 deaths were recorded, only 87 patients died from EC [16%], and 442 [84%] from other causes). Median CCI score for the study cohort was 0 (range, 0 to 12). On the basis of CCI, patients were grouped as follows: 0 score (group 1, n=1083), score 1–2 (group 2, n = 690), and score of 3 or more (group 3, n = 142). By CCI grouping, the 5- year RFS, DSS, and OS were 94%, 96%, and 97% for group 1, 92%, 94%, and 78% for group 2, and 86%, 95% and 60% for group 3 (P< 0.0001). The cause of death in the first 10 years after hysterectomy in our study was mainly non-uterine cancer-related (80% vs. 20% for uterine cancer-related) causes. On multivariate analyses, higher CCI, lymphovascular space invasion (LVSI), higher tumor grade, and older age were significant predictors of shorter OS. On multivariate analysis for DSS and RFS, only high tumor grade and LVSI were significant predictors.
Conclusion The cause of death for women with early-stage EC is mainly nonuterine cancer-related. Comorbidity score is a significant predictor of OS in our study cohort. Comorbidity scores may be useful as a stratification factor in any prospective clinical trial for women with early-stage EC.
Disclosures No disclosure
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