Comorbidity Is a Prognostic Factor in Elderly Patients with Head and Neck Cancer

Sanábria, Álvaro; Carvalho, André L.; Vartanian, José Guilherme; Magrin, José; Ikeda, Mauro Kasuo; Kowalski, Luiz Paulo

doi:10.1245/s10434-006-9296-1

Cited by 158 publications

(140 citation statements)

References 36 publications

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“…These conditions have direct impact on the care of the patient, selection of initial treatment, and evaluation of treatment effectiveness. [1][2][3] It has been demonstrated that comorbidity is an important prognostic factor for overall survival 4 and, in some studies, for locoregional control 5 in patients with malignant tumors of the head and neck area. Comorbidity may influence the choice of treatment, eg, leading to a more conservative approach to prevent possible postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

The prognostic role of comorbidity in salivary gland carcinoma

Terhaard

Schroeff

Schie

et al. 2008

Cancer

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BACKGROUND.Patients with head and neck cancer are prone to develop significant comorbidity mainly because of the high incidence of tobacco and alcohol abuse, both of which are etiologic and prognostic factors. However, to the authors' knowledge little is known regarding the prognostic relevance of comorbidity in patients with salivary gland cancer.METHODS.A retrospective cohort of 666 patients with salivary gland cancer was identified within the Dutch Head and Neck Oncology Cooperative Group database. For multivariate analysis, a Cox proportional hazards model was used to study the effect of comorbidity on overall survival and disease‐specific survival.RESULTS.According to the Adult Comorbidity Evaluation‐27 (ACE‐27) index, 394 patients (64%) had grade 0 comorbidity, 119 patients (19%) had grade 1 comorbidity, 71 patients (12%) had grade 2 comorbidity, and 29 patients (5%) had grade 3 comorbidity. In multivariate analysis for overall survival, the ACE‐27 comorbidity grade was a strong independent prognostic variable. The hazards ratio (HR) of death, including all causes, was 1.5 (95% confidence interval [CI], 1.1‐2.1) for patients with ACE‐27 grade 1 comorbidity versus grade 0 comorbidity (P < .007). The HR was 1.7 (95% CI, 1.2‐2.5) for grade 2 comorbidity (P = .003) and 2.7 (95% CI, 1.5‐4.7) for grade 3 comorbidity versus grade 0 comorbidity (P = .001). In the current analysis, ACE‐27 comorbidity grade was not an independent prognostic factor for disease‐free survival.CONCLUSIONS.To the authors' knowledge, this is the first study concerning the prevalence and relevance of the prognostic comorbidity variable ACE‐27 grade in patients with salivary gland cancer. Overall survival, but not disease‐free survival, was correlated strongly with ACE‐27 grade. Compared with other studies that investigated the effect of comorbidity on patients with head and neck cancer, patients with salivary gland cancer had less comorbidity. Their comorbid status appeared to be reasonably comparable to that of patients with other nonsmoking‐ and nonalcohol‐related cancers. Cancer 2008. © 2008 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

The prognostic role of comorbidity in salivary gland carcinoma

Terhaard

Schroeff

Schie

et al. 2008

Cancer

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“…W naszym materiale powikłanie to rozpoznaliśmy w 7 przypadkach (0,5%), w tym jeden był wynikiem zachłyśnięcia się kwaśną treścią żołądkową podczas indukcji znieczulenia. W piśmiennic-twie anglojęzycznym powikłanie to stwierdzano w 1,4-25% [5,7,17,20,40,50,51,54,64,77,87,125,156,158,183,204,218], podobnie w polskim: od 1,6% w materiale Gryczyńskiego i wsp., poprzez 3,1% u Szymańskiej-Skrzypczak i wsp. do 4,5% u Pajor i wsp.…”

Section: Powikłania Ze Strony Układu Oddechowegounclassified

“…oraz deCassia i wsp. stwierdza się przewagę powikłań u mężczyzn [21,183], a w pracy Penela i wsp. -przewagę kobiet [157].…”

Section: Powikłania W Zależności Od Płci Pacjentówunclassified

Powikłania ogólne operacji nowotworów złośliwych głowy i szyi

Sierszeń¹

2011

Otolaryngologia Polska

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“…Head and neck cancer is the eighth leading cause of cancer mortality worldwide [1]. According to the National Cancer Registry Programme, (Consolidated Report of the Population Based Cancer Registries 2000-2004) oral cancer is the eleventh most common cancer in the world with an estimated 267,000 cases and 128,000 deaths in 2000, twothirds of which is observed in developing countries.…”

Section: Introductionmentioning

confidence: 99%

“…There is a higher incidence of head and neck cancer in the older age group, primarily because of its relationship with chronic tobacco and alcohol consumption [2]. They also cause other significant systemic comorbidities which modify treatment tolerance and short term prognosis [1]. The relative impact of individual comorbidities which are diseases affecting cancer patients in addition to but not as a result of their index cancer may vary across different cancer types [3].…”

Section: Introductionmentioning

confidence: 99%

A Novel Morbidity Prediction Model for Head and Neck Oncosurgery

et al. 2010

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The purpose of the study was to construct and validate a risk model to predict morbidity in head and neck oncosurgeries. Potential risk factors of 300 surgically treated head and neck cancer patients like age, sex, tumor site, TNM stage, duration of surgery, adjunctive treatment, comorbidities and alcohol and tobacco usage were analyzed. Postoperative complications were noted. We developed a logistic model to predict the probability of patients developing morbidity based on the statistically significant variables-duration of surgery, preoperative radiation and hypertension. The validity of the test was assessed by the cindex which were 0.79 (95% C.I 0.71-0.87) for the study set (250 patients) and 0.86(95% C.I 0.73-0.90) for the test set (50 patients). The correlation of observed to expected morbidity was 0.709 (P<0.0001). We validated a risk model and constructed a simple chart that provides us an assessment of the risk of a patient of developing morbidity.

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Comorbidity Is a Prognostic Factor in Elderly Patients with Head and Neck Cancer

Abstract: Comorbidity measured with ACE-27 was a prognostic factor for overall survival in patients older than 70 years with head and neck cancer. The Karnofsky performance index could be included in multivariable analysis of survival for older patients with head and neck cancer.

Cited by 158 publications

References 36 publications

The prognostic role of comorbidity in salivary gland carcinoma

The prognostic role of comorbidity in salivary gland carcinoma

Powikłania ogólne operacji nowotworów złośliwych głowy i szyi

A Novel Morbidity Prediction Model for Head and Neck Oncosurgery

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