TY - JOUR T1 - Predictive Capacity of 3 Comorbidity Indices in Estimating Survival Endpoints in Women With Early-Stage Endometrial Carcinoma JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 1455 LP - 1460 DO - 10.1097/IGC.0000000000000802 VL - 26 IS - 8 AU - Karine A. Al Feghali AU - Jared R. Robbins AU - Meredith Mahan AU - Charlotte Burmeister AU - Nadia T. Khan AU - Nabila Rasool AU - Adnan Munkarah AU - Mohamed A. Elshaikh Y1 - 2016/10/01 UR - http://ijgc.bmj.com/content/26/8/1455.abstract N2 - Objective The negative impact of comorbidity on survival in women with endometrial carcinoma (EC) is well-known. Few validated comorbidity indices are available for clinical use, such as the Charlson Comorbidity Index (CCI), the Age-Adjusted CCI (AACCI), and the Adult Comorbidity Evaluation-27 (ACE-27). The aim of the study is to determine which index best correlates with survival endpoints in women with EC.Materials and Methods We identified 1132 women with early-stage EC treated at an academic center. Three scores were calculated for each patient using CCI, AACCI, and ACE-27 at the time of hysterectomy. Univariate and multivariable modeling was used to determine predictors of survival.Results For each of the studied comorbidity indices, the highest scores were significantly correlated with poorer overall survival. The hazard ratio of death from any cause was 3.92 for AACCI, 2.25 for CCI, and 1.57 for ACE-27. All 3 indices were independent predictors of overall survival with a P value of less than 0.001 on multivariate analysis. In addition, lymphovascular space invasion, lower uterine segment involvement, and tumor grade were predictors of overall survival. Lymphovascular space invasion, grade (P < 0.001), and high AACCI score were the only significant predictors of recurrence-free survival (RFS). Lymphovascular space invasion and tumor grade were the only 2 predictors of disease-specific survival.Conclusions Although all 3 studied comorbidity indices were significant predictors of overall survival in women with early-stage EC, AACCI showed a stronger association. It should be considered for evaluating comorbidity in women with early-stage EC. ER -