Dr Cannavale on the Importance of Assessing Comorbidities and Remission Rates in Ovarian Cancer

Kimberly Cannavale, MPH, Department of Research and Evaluation, Kaiser Permanente, discusses the rationale for conducting 

 of the impact of pre-existing comorbidities on remission rates in patients with epithelial ovarian cancer, highlighting potential next steps and the clinical implications of this research.

The study found that the presence of any Charlson comorbidity correlates with a lower likelihood of achieving complete remission (CR) in ovarian cancer, which is a highly significant finding, Cannavale begins. Prior research has explored how comorbidities affect overall survival (OS) in patients with ovarian cancer and has consistently shown an association between comorbidities and worse OS outcomes, she reports. However, whether this worsened prognosis was due to the direct impact of comorbidities, their influence on treatment efficacy, or a combination of both factors remained unclear, Cannavale explains.

Future studies should investigate the underlying mechanisms responsible for this association to guide treatment strategies for patients with ovarian cancer, she continues. For instance, it is possible that comorbidities interfere with the delivery of guideline-concordant treatments, reducing the effectiveness of standard approaches. Although there are no immediate plans to evaluate this relationship in current research, it remains a direction worth considering for future investigations, Cannavale states.

Overall, findings from the study contribute to the growing understanding that comorbidities may play a role, or at least partially influence, the reduced likelihood of achieving a CR in patients with ovarian cancer, she expands. Further exploration of this association could provide critical insights into how comorbidities affect treatment outcomes in this population. By understanding the broader impact of comorbidities on CR rates, clinicians may be better equipped to tailor treatment plans that account for these additional health challenges, ultimately improving both OS and quality of life for patients with ovarian cancer, Cannavale concludes.

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Kimberly Cannavale, MPH, discusses the clinical implications of a study on the impact of pre-existing comorbidities on remission rates in ovarian cancer.

Cannavale on the Importance of Assessing Comorbidities and Remission Rates in Ovarian Cancer

Cannavale on the Effect of Comorbidity on Remission Rates in Epithelial Ovarian Cancer

Kimberly Cannavale, MPH, project manager, Department of Research and Evaluation, Kaiser Permanente, 

discusses the rationale for conducting a retrospective cohort study

 investigating the effects of pre-existing comorbidities on remission rates in patients with epithelial ovarian cancer, highlighting the methodologies used throughout the study.

The rationale for this study stemmed from the need to understand how the COVID-19 pandemic affectedthe management and short-term outcomes of patients with ovarian cancer, Cannavale began. The study’s original analysis focused on how the pandemic period influenced remission rates, adjusting for comorbidities as a potential confounding factor, she reports. Notably, the analysis revealed that the presence of any Charlson comorbidity was linked to a lower likelihood of achieving complete remission (CR), Cannavale states, adding that this observation carries significant clinical implications.

Researchers identified patients with ovarian cancer through the Kaiser Permanente Southern California Cancer Registry or by chart review for those with an ICD-10 diagnosis code for ovarian cancer. The Charlson comorbidity index for each patient was calculated using data collected within a 12-month period prior to their ovarian cancer diagnosis, she indicated, adding that the index helped quantify the burden of comorbidities each patient had at the time of their diagnosis

To ascertain remission outcomes, the research team conducted a thorough chart review, considering physicians’ assessments, CA-125 lab values, and imaging evidence to determine whether the patients were in remission, Cannavale continues. Data on several potential confounders, including the pandemic period, age, race, ethnicity, International Federation of Gynecology and Obstetrics stage, prior length of membership, and time to treatment, were extracted from electronic medical records, she states.

The researchers employed bivariate and multivariable modified Poisson regressions, adjusting for these confounders, to evaluate the association between the Charlson comorbidity index and the likelihood of achieving CR or clinical remission by the end of treatment, Cannavale expands. The study focused on patients diagnosed with epithelial ovarian cancer subtypes between January 1, 2017, and June 30, 2021. Through this comprehensive analysis, the study shed light on how comorbidities and the pandemic period influenced remission outcomes in patients with ovarian cancer, she concludes.

Kimberly Cannavale, MPH, discusses the rationale for investigating the effect of pre-existing comorbidities on remission rates in ovarian cancer.

 Kimberly Cannavale, MPH, discusses findings from a retrospective study of comorbidity and remission outcomes in epithelial ovarian cancer.

Kimberly Cannavale, MPH, Department of Research and Evaluation, Kaiser Permanente, discusses findings from a retrospective cohort study of the impact of pre-existing comorbidities on remission rates in patients with epithelial ovarian cancer.

, investigators presented findings from the retrospective analysis which evaluated the impact of comorbidities on the likelihood of achieving complete and clinical remissions in patients with epithelial ovarian cancer. The study utilized the Charlson’s comorbidity index (CCI) to evaluate whether pre-existing comorbid conditions affected treatment outcomes in this patient population.

This investigation identified patients who were diagnosed with epithelial ovarian cancer at a large healthcare delivery system in the United States or via chart review. These patients were assessed using CCI to review a 12-month window prior to patient diagnosis. Treatment responses were ascertained through a combination of physician assessment, CA125 value, imaging, and chart review.

The analysis showed that patients with 1 or more comorbid conditions, as categorized by the CCI, had a lower likelihood of achieving complete remissions compared with patients who had no comorbid conditions, Cannavale reports.

A total of 799 patients were included in the study. In the crude analysis, those with a CCI score of 1, 2, or higher had a lower likelihood of achieving complete remission compared with those with a CCI score of 0. In the multivariable analysis, patients with a CCI score of 1, 2, or higher, again, had a lower likelihood of achieving complete remission compared with those who had a CCI score of 0. Similar results were observed for clinical remissions, although the associations were slightly weaker, investigators reported.

Furthermore, Cannavale reaffirms that in the multivariable analysis, the presence of 1 or more comorbid conditions was associated with a reduced likelihood of achieving complete remission. Similar results were observed for both clinical and complete remissions, she concludes.

Kimberly Cannavale, MPH

Articles

Cannavale on the Importance of Assessing Comorbidities and Remission Rates in Ovarian Cancer

Cannavale on the Effect of Comorbidity on Remission Rates in Epithelial Ovarian Cancer

Cannavale on Pre-Existing Comorbidities and Remission Rates in Epithelial Ovarian Cancer