Comparative analysis of extragenital pathology and of comorbidity indices in patients with uterine cancer

Abstract

Introduction. Cancer of the uterine body (СU) is a malignant hormone-dependent tumor with age-related characteristics, more common in pre- and postmenopausal women (75%). Comorbid pathology in the structure of acquired diseases is polymodal in nature, which makes it difficult to diagnose somatic pathology, choose tactics for diagnostic and therapeutic approaches, and prevent complications.Aim. To study the structure of extragenital pathology, the frequency and severity of comorbidity among the patients with CU using indices (CIRS, Charlson, Kaplan – Feinstein).Materials and methods. An observational retrospective cross-sectional study using the archival method was carried out, which included 100 women with verified RTM stages I–III. In order to assess the effect of age on the structure and incidence of comorbid pathology, patients were divided into two groups: group I (n = 39) under the age of 55 years, group II (n = 61) – over 55 years.Results. In the structure of somatic pathology in patients with endometrial cancer in both groups, diseases of the cardiovascular system (64.1% and 91.8%), endocrine system, metabolic disorders (28.2% and 55.7%), organs digestion (28.2% and 24.6%). At the same time, diseases of the cardiovascular system (p < 0.001), endocrine system and metabolic disorders (p < 0.001) statistically significantly prevailed in patients older than 55 years. The average number of nosological forms of somatic pathology was significantly lower in group I (Me – 2), compared with patients in group II (Me – 3, p < 0.05). When using the M. Charlson scale to analyze the frequency of comorbidity in group II, somatic pathology was diagnosed in 100% of cases, which is significantly higher than in group I, and cases with moderate comorbidity predominated more often (2.7 times, higher in group II compared with I) and pronounced comorbidity (10 times). When analyzing the frequency of comorbidity according to the CIRS scale (Cumulative Illness Rating Scale-Geriatric) and the Kaplan – Feinstein index, no significant differences were found in the studied groups.Conclusion. Patients in the second group were significantly more likely to have arterial hypertension, coronary heart disease, hyperlipidemia, type 2 diabetes mellitus were significantly more often detected compared to patients in group I. When conducting a comparative characteristic of methods for assessing comorbidity, it was found that the highest level of reliability in the frequency of comorbid pathology was registered when using the M. Charlson scale (p < 0.001).