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.