Evaluating Comorbidity Scores in Geriatric Ovarian Cancer: A Retrospective Cohort Analysis

TL;DR

This study found that the Charlson Comorbidity Index best predicts survival and recurrence in older ovarian cancer patients.

Contribution

The study is novel in comparing multiple comorbidity scores to determine their predictive accuracy in geriatric ovarian cancer patients.

Findings

Higher Charlson Comorbidity Index (CCI) scores were independently associated with shorter survival in multivariate analysis.

Other comorbidity scores lost statistical significance in multivariate models despite showing univariate associations with survival.

Higher comorbidity burden correlated with more frequent disease recurrence and shorter time to recurrence.

Abstract

Background and Objectives: This study aimed to comparatively evaluate the association of commonly used comorbidity scores with survival, mortality, and recurrence in ovarian cancer patients aged 50 years and above. Materials and Methods: In this single-center, retrospective study, 130 female patients diagnosed between 2017 and 2024 who had received systemic therapy and had complete medical records were included. Comorbidity scores—including the Charlson Comorbidity Index (CCI), Cumulative Illness Rating Scale-Geriatric (CIRS-G), Adult Comorbidity Evaluation-27 (ACE-27), Elixhauser Comorbidity Index, Index of Coexistent Disease (ICED), and Functional Comorbidity Index (FCI)—were calculated for each patient. Survival analyses were conducted using the Kaplan–Meier method and Cox regression modeling. The prognostic accuracy of comorbidity scores was assessed via receiver operating characteristic (ROC) curve analysis. Results: Patients with higher CCI scores had significantly shorter survival, and CCI was identified as an independent prognostic factor in multivariate analysis. While other comorbidity scores were associated with overall survival in univariate analyses, they lost statistical significance in multivariate models. Patients with a higher comorbidity burden experienced more frequent disease recurrence and shorter time to recurrence. Conclusions: Comorbidity burden is a key clinical determinant of survival and disease trajectory in older patients with ovarian cancer. The CCI demonstrated the highest prognostic accuracy in this population and may serve as a valuable tool in individualized treatment planning. Integration of comorbidity-based assessments into standard decision-making processes is recommended in geriatric oncology practice.

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