Comparison of Comorbidity Indices for Patients With Head and Neck Cancer

Piccirillo, Jay F.; Spitznagel, Edward L.; Vermani, Nisha; Costas, Irene; Schnitzler, Mark

doi:10.1097/01.mlr.0000124254.88292.a1

Cited by 67 publications

(48 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Radiation oncologists provided information on the primary tumor: site, dimensions, and clinical tumor-node-metastasis stage. Comorbidities were assessed using the Charlson comorbidity index (36). Follow-up visits with study nurses and radiation oncologist were scheduled immediately at the end of the radiation therapy, 1 month later, and then every 6 months for the first 3 years followed by once a year until the end of the study (June 30, 2003).…”

Section: Methodsmentioning

confidence: 99%

Prognostic Significance of Cyclooxygenase-2 Overexpression in Glottic Cancer

Sackett¹,

Bairati

Meyer

et al. 2008

Clinical Cancer Research

View full text Add to dashboard Cite

Purpose: Cyclooxygenase-2 (COX-2) overexpression has been associated with a poor prognosis in many cancers. However, the role of COX-2 overexpression in head and neck cancers remains undetermined.The objective of this study was to evaluate whether COX-2 is a prognostic factor in glottic cancer. Experimental Design: This study was part of a phase III placebo-controlled randomized trial evaluating the efficacy of a-tocopherol in reducing second primary cancers (SPC) in head and neck cancer patients. Immunohistochemical analyses were conducted on pretreatment biopsies of 301patients with early-stage glottic cancer treated by radiotherapy. The median value of 50% of positive tumor cells was the cutoff point used to define COX-2 overexpression. Outcomes considered in the statistical analysis were recurrence, SPC, and death. The Cox proportional hazards model was used to estimate the hazard ratios (HR) and their 95% confidence intervals (95% CI). Results: The HR associated with COX-2 overexpression was 0.94 (95% CI, 0.55-1.62) for recurrence. The HR associated with SPC was 2.63 (95% CI, 1.32-5.23) for the first 3.5 years of follow-up and 0.55 (95% CI, 0.22-1.32) for the following 3.5 years. The HR associated with COX-2 overexpression was 1.57 (95% CI, 1.01-2.45) for overall mortality. Conclusions: COX-2 overexpression in glottic cancer was associated with increased overall mortality and an increased risk of SPC during the early follow-up period. Future studies are needed to explain observed effects on SPC. COX-2 expression may prove helpful in defining an individual patient's prognosis.Glottic cancer is the most common early-stage head and neck cancer. The 5-year overall survival rate is between 72% and 85% for stage I cancer and from 59% to 77% for stage II cancer (1 -3). Local recurrence occurs in about 6% to 28% of patients within 5 years (1). Another important outcome for patients with early-stage glottic cancer is the occurrence of a second primary cancer (SPC), which is discovered in 15% to 18% of the patients within 5 years and is associated with poor survival (2, 4, 5). The most common site of SPC is the upper aerodigestive tract (2, 5). SPCs are attributed to a ''field cancerization'' effect induced by carcinogens such as tobacco, which can alter the respiratory, oral, and esophageal mucosa (6, 7). Although the early stage of glottic cancer is relatively well controlled by therapy, prognosis of these patients is often compromised by the occurrence of SPC.Cyclooxygenase (COX) is the rate-limiting enzyme in the conversion of arachidonic acid into prostaglandins. It exists in two isoforms, COX-1, which is constitutional, and COX-2, which can be induced by stimuli such as smoking and radiotherapy (8-10). COX-2 overexpression increases prostaglandins, which are known to promote tumor development, invasion, and metastasis by many mechanisms, most importantly by stimulating angiogenesis through the action of vascular endothelial growth (11)(12)(13). Prostaglandins also induce cell proliferation, reduce apop...

show abstract

Section: Methodsmentioning

confidence: 99%

Prognostic Significance of Cyclooxygenase-2 Overexpression in Glottic Cancer

Sackett¹,

Bairati

Meyer

et al. 2008

Clinical Cancer Research

View full text Add to dashboard Cite

show abstract

“…Creating study-specific measures may not be possible, however, and investigators often apply measures in a manner at variance from how they were developed. 10,12,[16][17][18] In this study, we identified 4 administrative claims-based measures of comorbidity that have been used frequently in the health services literature to adjust for baseline health status and compared their performance in predicting 2 outcomes of importance to cancer care researchers-receipt of recommended adjuvant chemotherapy and mortality-among stage III colon cancer patients. We chose to study stage III colon cancer patients for several reasons.…”

mentioning

confidence: 99%

In Search of the Perfect Comorbidity Measure for Use With Administrative Claims Data

et al. 2006

View full text Add to dashboard Cite

show abstract

“…4,[6][7][8][9][10] Collectively these data provide evidence for a 2 to 8-fold elevated risk of CLL in case relatives.…”

Section: Familial Risks Of Chronic Lymphocytic Leukemiamentioning

confidence: 76%

“…3 Disease-specific comorbidity measures are developed and tested in a single disease population, and intended for use only in that setting. 8 They have a conceptual advantage in that they account for specific treatments and outcomes unique to the population of interest. 6 A major limitation in implementing either general or disease-specific measures is the data source used for their generation.…”

mentioning

confidence: 99%