The Impact of Comorbidity and Age on Survival with Laryngeal Cancer

Abstract

Previous studies ha ve evaluated the effe cts of como rbidity on survival in patient s with cance r. We app lied the Charlson comorbidity index (CCl) to a coho rt ofpatients with laryngeal cance r to validate its use and to assess the prognosti c impact of age . Our study p opulation consisted of 152 patients with laryngeal cance r who we re see n ove r a JO-yearperiod. Patient s we re ass igned CCl sco res and were catego rized into low-and high -grade como rbidity groups fo r comparison. Age adjustm ents we re p erformed by adding 1 p oint to the Charl son sco re f or each decad e ove r the median age.Low-vs. highgrade comorbidity was a valid predictor of survival independ ent of TNM (tum or, nodes, and m etastases) stage. Low-grade comorbidity was present in 126 patients; their median survival was 41 months. Highgrade comorbidity was p resent in 26 patients ; their median survival was 8 mon ths (p = 0.0002). The addition of the age factor to the CCl did not improve our prognostic ability. There was no difference in CCI groups with respect to tobacco and alcohol use, gender, treatment modality, or mean time to recurrence. The incidence and severity of complications were also similar in the two groups .We conclude that the CCI is a stro ng predictor of surv ival in patient s with laryngeal cance r. The conf ounding effects of com orbidity sho uld be considere d in the TNM stag ing of laryngeal cance r to improve our p rognosti c ability. Further investigat ions are necessary to assess the validity ofthis ind ex in patients with othe r head and neck cance rs.

Age‐adjusted comorbidity and survival in locally advanced laryngeal cancer

“…But, in contrast to our results, incorporating age as an additional comorbid condition did not improve the prognostic ability of the CCI. (6) The current study, however, examined the prognostic impact of age and comorbidities in a uniform cohort of T3–T4 laryngeal SCC. We demonstrated, matching with data reported in previous studies, that both age and comorbidities are strong prognostic factors in locally advanced larynx cancer independent of treatment modality due to the high impact of both factors on non-cancer related competing mortality risk.…”

“…These patients are at a greater risk for cardiovascular and respiratory illnesses in addition to the development of squamous cell carcinoma (SCC) in the aerodigestive tract. (1–6) Up to 65% of patients with head and neck cancer are afflicted with clinically relevant pretreatment comorbidities. (3, 5, 7, 8) …”

Effects of tumour stage, comorbidity and therapy on survival of laryngeal cancer patients: a systematic review and a meta-analysis

“…In addition, severe comorbidity (e.g. cardiovascular disease) seems to be a predictor for shorter survival times of laryngeal cancer patients [18][19][20][21].…”

Measuring Comorbidity in Patients With Head and Neck Cancer

“…There was no difference between indexes in the survival analysis. Sabin et al 17 reported the survival analysis for a series of 152 patients with laryngeal cancer and found the Charlson Index to be a predictor of survival using univariate, Kaplan‐Meier, and Cox regression analysis. Piccirillo has reported the score distributions and 2‐year survival analysis using a modification of the KFC 18 for a series of 341 patients.…”