Predictive value of comorbidity and anemia on outcome in patients with sinonasal carcinoma

Becker, Christoph; Dahlem, Kilian Konrad Kenjiro; Lange, Kitty; Ketterer, Manuel Christoph; Pfeiffer, Jens

doi:10.1016/j.jcms.2018.05.009

Cited by 3 publications

(4 citation statements)

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“…The sinonasal anatomy involves complex interplay between structure and empty space, which contributes to late presentation, poor prognosis, higher complexity of treatment, and greater impact of comorbid disease on treatment success and patient survival . Factors such as anemia, obesity, nutrient deficiencies, chronic inflammation, stress, and many other comorbid conditions contribute to immunosuppression, poorer response to cancer treatment, and worse survival outcomes . Comorbidities are important in cancer survivorship because they could be markers of general health of patients, and are considered both prognostic and competing causes of cancer mortality .…”

Section: Introductionmentioning

confidence: 99%

Comorbidity burden and nonclinical factors associated with sinonasal cancer all‐cause mortality

et al. 2019

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Objective: To describe comorbidity burden and nonclinical factors associated with all-cause mortality of sinonasal cancer in the United States.Methods: The National Cancer Database (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013) was queried for adult cases of sinonasal cancer (n = 10,518). Outcome of interest was all-cause mortality. Independent variables included comorbidity score and nonclinical factors such as age, gender, race, facility type, distance to facility, insurance, and income. Survival analysis was conducted via multivariable extended Cox regression with Heaviside adjustments.Results: Patients were mostly (79%), male (61%), and mean age of diagnosis was 63.5 years. Approximately one in five patients (18.7%) had a major comorbid condition (Charlson-Deyo score ≥ 1) at diagnosis. After adjusting for clinical factors, increasing comorbidity score was associated with a corresponding increase in hazard of mortality (aHR comorbidity score of 1 = 1.25; 95% CI, 1.16, 1.35), (aHR score of 2+ = 1.61; 95%, CI 1.41, 1.83). Hazard of mortality was also associated with being male (aHR = 1.11; 95% CI, 1.04, 1.17); black (aHR = 1.13, 95% CI, 1.03, 1.24); uninsured (aHR = 1.45; 95% CI, 1.25, 1.68) or on Medicaid (aHR = 1.50; 95% CI, 1.33, 1.69); residence in zip codes with lower median income quartile (aHR < $30,000 = 1.17; 95% CI, 1.06, 1.29); and treatment at community cancer programs (aHR = 1.14, 95% CI 1.01, 1.28).Conclusion: Comorbid disease is associated with all-cause sinonasal cancer mortality, and after accounting for known clinical factors, significant differences in mortality persist based on disparity-driven, nonclinical factors.

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Section: Introductionmentioning

confidence: 99%

Comorbidity burden and nonclinical factors associated with sinonasal cancer all‐cause mortality

et al. 2019

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“…Previous reports have demonstrated the impact of comorbidities using the CCI on OS postoperatively in several malignant diseases [11–32, 39–74] (Table 8). In HCC patients, previous retrospective studies demonstrated the association between the CCI and prognosis after surgery [73, 74].…”

Section: Discussionmentioning

confidence: 99%

“…Because aging has been determined to influence prognosis, the age‐adjusted CCI (ACCI) was developed to correct the final score of the CCI [10]. Several studies have demonstrated the clinical impact of the ACCI in patients with various types of malignant diseases [11–32]. However, there have been no studies investigating the prognostic impact of the ACCI on short‐ and long‐term outcomes in patients with HCC.…”

Section: Introductionmentioning

confidence: 99%

Predictive Value of the Age‐Adjusted Charlson Comorbidity Index for Outcomes After Hepatic Resection of Hepatocellular Carcinoma

et al. 2020

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Background This study aimed to evaluate the impact of the age-adjusted Charlson comorbidity index (ACCI) on outcomes after hepatic resection for hepatocellular carcinoma (HCC). Methods We assessed 763 patients who underwent hepatic resection for HCC. The ACCI scores were categorized as follows: ACCI B 5, ACCI = 6, and ACCI C 7. Results A multivariate analysis showed that the odds ratios for postoperative complications in ACCI = 6 and ACCI C 7 groups, with reference to ACCI B 5 group, were 0.71 (p = 0.41) and 4.15 (p \ 0.001), respectively. The hazard ratios for overall survival of ACCI = 6 and ACCI C 7 groups, with reference to ACCI B 5 group, were 1.52 (p = 0.023) and 2.45 (p \ 0.001), respectively. The distribution of deaths due to HCC-related, liver-related, and other causes was 68.2%, 11.8%, and 20% in ACCI B 5 group, 47.2%, 13.9%, and 38.9% in ACCI = 6 group, and 27.3%, 9.1%, and 63.6% in ACCI C 7 group (p = 0.053; ACCI B 5 vs. = 6, p = 0.19; ACCI = 6 vs. C 7, p \ 0.001; ACCI B 5 vs. C 7). In terms of the treatment for HCC recurrence in ACCI B 5, ACCI = 6, and ACCI C 7 groups, adaptation rate of surgical resection was 20.1%, 7.3%, and 11.1% and the rate of palliative therapy was 4.3%, 12.2%, and 22.2%, respectively. Conclusions The ACCI predicted the short-term and long-term outcomes after hepatic resection of HCC. These findings will help physicians establish a treatment strategy for HCC patients with comorbidities.

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“…Furthermore, the mean OS and DFS of patients with anemia were significantly lower than of patients without any signs of anemia in both male and female anemic patients. Whereas Becker et al [6] described anemia as having a significant impact on OS in sinonasal cancer, Baumeister et al [5] described the influence of anemia on survival rates in oropharyngeal cancer. There are case reports and studies with much smaller cohorts, showing a significant coherence between anemia and survival in laryngeal cancer patients, but to the best of our knowledge, this is the largest study focusing on laryngeal cancer and anemia.…”

Section: Impact and Importance Of Comorbiditiesmentioning

confidence: 99%

Surgical nodal management in hypopharyngeal and laryngeal cancer

Ketterer

Moraga

Beitinger

et al. 2020

Eur Arch Otorhinolaryngol

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Objective The aim of this study is to compare pre-therapeutic staging of the loco-regional lymphatic basin and subsequent surgical management in cN0 versus cN+ hypopharyngeal and laryngeal cancer patients. Methods We analyzed all hypopharyngeal and laryngeal carcinoma patients treated surgically at a single quaternary medical care and cancer center between 2004 and 2014. We established two groups for patients who underwent neck dissection comparing patients with a low LNR (lymph node ratio) to one with a high LNR. Regarding the cN0 cohort, elective neck dissection was evaluated as a secondary predictor variable. Comorbidities, such as anemia and renal insufficiency, were analyzed as potentially influencing disease-free (DFS) and overall survival (OS). Results A total of 310 patients (185 glottic and 125 supraglottic/hypopharyngeal carcinoma) were included. Pre-therapeutic neck MRI-/CT-scan and concomitant neck ultrasound revealed cN+ status in 144 patients resulting in a significant overstaging in 63 patients (44%) who were rated as being pN0 after histological examination. 166 patients were staged cN0 and 21 underwent elective neck dissection (11 local advanced glottic and 10 supraglottic/hypopharyngeal carcinoma). Two cN0 patients showed occult cervical lymph node metastases (10%). Furthermore, we could detect a significant negative impact of the LNR divided by the number of dissected lymph nodes and OS. Conclusion The pre-therapeutic clinical evaluation of lymphatic outgrowth is over-staged. OS decreases with increasing LNR divided by the number of dissected lymph nodes. Renal insufficiency and anemia are significant negative factors, decreasing both OS and DFS. KeywordsHypopharyngeal carcinoma · Laryngeal carcinoma · Overall survival · cN0 · Elective neck dissection · Head and neck cancer Abbreviations CT Computed tomography DFS Disease-free survival DM Distant metastasis HNSCC Head and neck squamous cell carcinoma LNR Lymph node ratio MRI

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Predictive value of comorbidity and anemia on outcome in patients with sinonasal carcinoma

Cited by 3 publications

References 33 publications

Comorbidity burden and nonclinical factors associated with sinonasal cancer all‐cause mortality

Comorbidity burden and nonclinical factors associated with sinonasal cancer all‐cause mortality

Predictive Value of the Age‐Adjusted Charlson Comorbidity Index for Outcomes After Hepatic Resection of Hepatocellular Carcinoma

Surgical nodal management in hypopharyngeal and laryngeal cancer

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