ACE-27 as a prognostic tool of severe acute toxicities in patients with head and neck cancer treated with chemoradiotherapy: a real-world, prospective, observational study

Monteiro, Ana Raquel; Garcia, Ana Rita; Pereira, Tatiana Cunha; Macedo, Filipa; Soares, R. Félix; Pereira, Kayla; Serra, Tânia; Khouri, Leila; Ribeiro, João; Teixeira, Margarida

doi:10.1007/s00520-020-05679-4

Cited by 16 publications

(9 citation statements)

References 29 publications

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“…44 ACE-27 is a score that has been extensively tested in the HN cancer population: major postoperative complications, 20,45 overall survival, and short-term mortality, 46 and even severe acute toxicity after chemoradiation protocols. 47 Of note, while ACE-27 is a predictor of postinsertion complications, the ASA class did not. Problems of interrater reliability may represent a limitation of this score as a risk predictor.…”

Section: Discussionmentioning

confidence: 96%

A 5-year experience with midline catheters in the management of major head and neck surgery patients

et al. 2022

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Background: In the perioperative management of major head and neck surgery (HNS) patients, the performance of midline catheters (MCs) has been never tested. We present here our 5-year experience by reporting MC-related complications and by identifying the preoperative risk factors associated with their development. Methods: Clinical variables were extracted and the dwell time, the number, and the type of postprocedural complications of MCs were retrieved. Complications were classified into major (needing MCs removal and including catheter-related bloodstream infection or deep vein thrombosis or catheter occlusion) and into minor (accidental dislodgement, leaking, etc.). Descriptive statistics and logistic regression models were used in order to identify the predictors of complications. Results: A total of 265 patients were included, with a mean age of 67.4 years. Intraprocedural complications occurred in 1.1% of cases, while postprocedural complications occurred in 13.9% of cases (12.05/1000 days), but they were minor in more than 7.0% (5.4/1000 catheter-days). There were 19 minor complications (7.1% or 5.4/1000 catheter-days) while 18 (7%, 5.1/1000 catheter-days) patients experienced at least one major complication. Female sex (OR = 1.963, 95% CI 1.017–3.792), insertion in the right arm (OR = 2.473, 95% CI 1.150–5.318), and an ACE-27 score >1 (OR = 2.573, 95% CI 1.295–5.110) were independent predictors of major complications. Conclusions: MCs appear to represent an effective option in the setting of major HNS. The identification of patients most at risk for MC-related complications should prompt a postoperative watchful evaluation.

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Section: Discussionmentioning

confidence: 96%

A 5-year experience with midline catheters in the management of major head and neck surgery patients

et al. 2022

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“…ACE-27 is widely used for co-morbidity assessment across different cancers; it has been shown to predict severe acute toxicity, early mortality, as well as long-term prognosis in HNC. 4,10,32,33 ACE-27 differs from other co-morbidity indices covered here in that it grades overall severity of co-morbidity from 0 (no co-morbidity) to 3 (severe co-morbidity). 12 It also covers a wider scope of co-morbid conditions compared with other co-morbidity indices under review.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Early Mortality in Head and Neck Cancer Patients Undergoing Definitive Chemoradiation

Tsui

Cheung

Chow

et al. 2022

Hong Kong Journal of Radiology

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Introduction: Head and neck cancer (HNC) afflicts >16,000 people in Hong Kong annually. Non-operative treatment for HNC typically involves radiotherapy (with or without concurrent systemic therapy) and is associated with significant acute toxicity. Demography, tumour factors, and co-morbidities each influence treatment outcome and prognosis, but their role in predicting 90-day mortality is less well-known.

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“…Patient evaluations included laboratory testing for the following: Complete blood count; coagulation profile (INR, TQ and AP); erythrocyte sedimentation rate (ESR), glucose, urea, creatinine levels; bilirubin; serum alanine aminotransferase (ALT); serum aspartate aminotransferase (AST), sodium, potassium, serum amylase and C-reactive protein (CRP). Questionnaires were used to assess patient outcome, including Adult Comorbidity Evaluation-27 (ACE-27) for significant ailments ( 10 ), Karnofsky Performance Status Scale (KPSS) ( 11 ) for functional impairment and better understand patient requirements and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire ( 12 ) with the Head and Neck Cancer Module (EORTC QLQ-H&N35), with the commission's approval for use.…”

Section: Case Reportmentioning

confidence: 99%

“…A common side effect of radiation therapy is the sensory impairment of the mucosa, which is an important etiological mechanism in swallowing disorders and aspiration ( 1 , 18 ). In addition, both surgical treatment and radiation therapy can alter laryngeal innervation and functions ( 10 ) ( Table I ).…”

Section: Case Reportmentioning

confidence: 99%

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Quality of life and tracheostomy influence in successfully treated hypopharyngeal cancer: A case report

Cordunianu

Ganea²,

Cordunianu

et al. 2022

Exp Ther Med

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Squamous cell carcinoma (SCC) of the hypopharynx is associated with the worst prognosis of all squamous cell cancer types of the head and neck, with a rich submucosal lymphatic network and a significant inferior extent. Generally, cancers of the head and neck have a big impact on the quality of life (QoL) in patients, both before and after treatment, due to the fact that most cases are diagnosed in advanced stages, with lymph node metastases and have an aggressive pattern associated with low survival rates. The present case report aimed to see the evolution of a patient successfully treated for hypopharyngeal cancer with conservation therapies from the QoL perspective and the influence made by the presence of tracheostomy. Variables, including clinical parameters (sex, age, TNM classification, performance status, histological type and tumor subsite), local control, QoL, Adult Comorbidity Evaluation-27 score and overall survival were assessed, according to the American Joint Committee on Cancer 8th edition, for a 58-year-old patient treated with conservation therapies and tracheostomy in a tertiary center. Subjective features measured through the QoL questionnaire had scores with lowering tendencies during the treatment period. The patient was provided with early training for tracheostomy care and early discharge education. The following objective features of treatment response were exhibited: Hemoglobin levels, leukocyte count, tumor size, imagistic evaluations and local control to confirm treatment response. It is essential when planning the treatment of aggressive and rare pathologies, such as hypopharyngeal cancer, to consider the QoL and patient choice for better adherence. Overall, the results demonstrated that the initial requirement for emergency tracheostomy was not associated with any ulterior complications and did not influence the end result of the treatment.

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ACE-27 as a prognostic tool of severe acute toxicities in patients with head and neck cancer treated with chemoradiotherapy: a real-world, prospective, observational study

Cited by 16 publications

References 29 publications

A 5-year experience with midline catheters in the management of major head and neck surgery patients

A 5-year experience with midline catheters in the management of major head and neck surgery patients

Risk Factors for Early Mortality in Head and Neck Cancer Patients Undergoing Definitive Chemoradiation

Quality of life and tracheostomy influence in successfully treated hypopharyngeal cancer: A case report

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