Impact of comorbidity on therapeutic decision‐making in head and neck cancer: Audit from a comprehensive cancer center in India

Abstract

Comorbidity in patients with head and neck cancer can influence therapeutic decision-making. Prospective longitudinal rigorous collection of comorbidity data is warranted for correlation with outcomes. ACE-27 may be a clinically more meaningful tool for comorbidity assessment.

Influence of comorbidity on therapeutic decision making and impact on outcomes in patients with head and neck squamous cell cancers: Results from a prospective cohort study

“…3 Approximately, one fifth of the patient population had moderate to severe comorbidity, a prevalence rate similar to that reported by Piccirrilo et al 12 Overall, our study demonstrates that a higher grade of comorbidity predicts for greater deviation from an ideal treatment plan, which in turn results in a suboptimal outcomes. Nearly two thirds of the patient population in current study had some comorbidity which is higher than that reported in our previous study.…”

“…3 The reasons for deviation from the ideal treatment plan were noted in the CRF. 3 The reasons for deviation from the ideal treatment plan were noted in the CRF.…”

“…10 Evidence-based treatment guidelines targeted at this population are inadequate, partly as these patients are often excluded from clinical trials. 3 The primary objective of our study was to estimate the prevalence and severity of comorbidity, its influence on therapeutic decision making, and impact on resultant outcomes in a prospective cohort of patients with HNSCC presenting to our institute for management. 3 The primary objective of our study was to estimate the prevalence and severity of comorbidity, its influence on therapeutic decision making, and impact on resultant outcomes in a prospective cohort of patients with HNSCC presenting to our institute for management.…”

Treatment, comorbidity and survival in stage III laryngeal cancer

“…Comorbidity is an infrequently reported variable in either large‐scale clinical trials comparing different treatment arms or in registry‐based studies exploring outcome trends, however, our study supports emerging literature citing its importance . The comprehensive ACE‐27 score used in this study includes 27 variables graded by severity, including alcohol use, cardiorespiratory disease, and previous/concurrent carcinomas.…”

“…If there is agreement upon anything, it is that personalized treatment incorporating both patient and tumor variables is likely to yield optimal survival and functional outcomes . This is particularly pertinent in a patient population with a high burden of smoking and alcohol‐associated comorbidities, which may influence treatment options and survival . Second, laryngeal function, rather than conservation alone, is recognized as an important yet infrequently studied outcome in its own right .…”