Muhammet Senkal

Evaluating Comorbidity Scores in Geriatric Ovarian Cancer: A Retrospective Cohort Analysis

Background and Objectives: This study aimed to comparatively evaluate the association of commonly used comorbidity scores with survival, mortality, and recurrence in ovarian cancer patients aged 50 years and above. Materials and Methods: In this single-center, retrospective study, 130 female patients diagnosed between 2017 and 2024 who had received systemic therapy and had complete medical records were included. Comorbidity scores—including the Charlson Comorbidity Index (CCI), Cumulative Illness Rating Scale-Geriatric (CIRS-G), Adult Comorbidity Evaluation-27 (ACE-27), Elixhauser Comorbidity Index, Index of Coexistent Disease (ICED), and Functional Comorbidity Index (FCI)—were calculated for each patient. Survival analyses were conducted using the Kaplan–Meier method and Cox regression modeling. The prognostic accuracy of comorbidity scores was assessed via receiver operating characteristic (ROC) curve analysis. Results: Patients with higher CCI scores had significantly shorter survival, and CCI was identified as an independent prognostic factor in multivariate analysis. While other comorbidity scores were associated with overall survival in univariate analyses, they lost statistical significance in multivariate models. Patients with a higher comorbidity burden experienced more frequent disease recurrence and shorter time to recurrence. Conclusions: Comorbidity burden is a key clinical determinant of survival and disease trajectory in older patients with ovarian cancer. The CCI demonstrated the highest prognostic accuracy in this population and may serve as a valuable tool in individualized treatment planning. Integration of comorbidity-based assessments into standard decision-making processes is recommended in geriatric oncology practice.

Association Between Adipose Tissue Distribution and Survival in Recurrent Ovarian Cancer Patients Treated With Anti‐ VEGF Therapy: A Retrospective CT ‐Based Analysis

ABSTRACT Objective The aim of this study was to evaluate the effect of visceral, subcutaneous and intermuscular adipose tissue areas measured by computed tomography at diagnosis on survival in ovarian cancer patients receiving second‐line bevacizumab treatment. Materials and Methods This retrospective study included 41 ovarian cancer patients who received second‐line bevacizumab treatment at Istanbul University Oncology Institute between 2009 and 2024. Visceral, subcutaneous and intermuscular adipose tissue areas at the L3 and T12 vertebral levels were measured from the computed tomography images of the patients at the time of diagnosis, and these areas were normalized by the square of body height and index values (cm 2 /m 2 ) were calculated. The effect of adipose tissue parameters on overall survival and disease‐free survival was analyzed. Results In multivariate analysis, only subcutaneous adipose tissue at the T12 level was found to be an independent predictor of overall survival. Subgroup analyses also showed that survival was significantly shorter in patients with low subcutaneous fat area or index. Similarly, low body mass index was also associated with unfavorable survival outcomes. Visceral and intermuscular adipose tissue parameters had no significant effect on survival. Conclusion Subcutaneous adipose tissue measured by diagnostic computed tomography may serve as a potential prognostic biomarker in ovarian cancer patients. These findings support the integration of body composition analysis into clinical decision‐making processes.