A high prevalence of age-related chronic diseases, comorbidity, is observed among gynecologic cancer patients. Conducted studies indicate that comorbidity has a negative prognostic impact in gynecological cancer but the precise causal relations are not yet known.
The aim of the first study of the project is to develop and validate a new tool for classification of comorbidity, based on modern treatment modalities. This new comorbidity index will afterwards be used to investigate the impact of comorbidity on short-term and long-term overall and cancer-specific survival in ovarian and uterine corpus cancer.
The aim of the second part of the project is to investigate the influence of comorbidity on cancer treatment and complications related to treatment and to compare the impact of comorbidity to other known prognostic factors.
Third study of the project is part of a Nordic Benchmarking study in which we try to establish if differences in prevalence and management of comorbidity can explain the observed differences in survival among ovarian cancer patients in the Nordic countries.
Materials and methods
The project is a register-based cohort study based on data from approximately 9000 women registered in the Danish Gynecological Cancer Database (DGCD) with ovarian or uterine corpus cancer. Supplementary information will be obtained from the National Patient Registry. The statistical analyses will be performed by Biostatistician Ib Jarle Christensen and includes Kaplan- Meier survival statistics, Cox multivariate analyses and regression analyses.
The development of a new comorbidity index includes a discovery phase followed by a validation study conducted on data from a different cohort of Danish ovarian cancer patients. Further is validation of the index on Swedish and Norwegian comparable cohorts planned.
This study will provide us with a new tool for classifying comorbidity and will clarify where in the treatment system patients with comorbidity today are experiencing sub-optimal care. Based on the results from our study a warning system for patients requiring special attention and treatment can be established. Ultimately this may decrease morbidity and increase survival in cancer patients burdened by comorbidity.
Mette Calundann Noer
PhD student, MD
Dept. of Gynecology, Juliane Marie Centre, entrance 7821
Rigshospitalet, Blegdamsvej 9
Tlf.: +45 25 727 352