Comorbidity is an independent prognostic factor in women with uterine corpus cancer: a nationwide cohort study

Objective To determine whether comorbidity independently affects overall survival in women with uterine corpus cancer. Design Cohort study. Setting Denmark. Study population A total of 4244 patients registered in the Danish Gynecologic Cancer database with uterine corpus cancer from 1 January 2005 until 13 October 2011. Methods All patients included in the study were assigned a comorbidity score according to the Charlson Comorbidity Index. Multivariate survival analyses were performed to investigate the prognostic impact of comorbidity adjusting for known prognostic factors. As performance status might capture the prognostic impact of comorbidity and because information on the variable grade was missing in some special histological subtypes, we included different models in the multivariate analyses with and without PS and grade, respectively. Main outcome measures Overall survival. Results Univariate survival analysis showed a significant ( p  < 0.001) negative association between increasing level of comorbidity and overall survival. Multivariate analyses adjusting for other prognostic factors showed that comorbidity is a significant independent prognostic factor with hazard ratios ranging from 1.27 to 1.42 in mild, 1.69 to 1.74 in moderate, and 1.72 to 2.48 in severe comorbidity. Performance status was independently associated to overall survival and was found to slightly reduce the prognostic impact of comorbidity. Conclusion Comorbidity is an independent prognostic factor in uterine corpus cancer and increasing levels of comorbidity are associated with shorter survival.