The impact of comorbidity on treatment-related side effects in older patients with laryngeal cancer

Peters, Thomas; Laan, Bernard F. A. M. van der; Plaat, Boudewijn E. C.; Wedman, Jan; Langendijk, Johannes A.; Halmos, György B.

doi:10.1016/j.oraloncology.2010.10.016

Cited by 42 publications

(46 citation statements)

References 27 publications

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“…With the rapid growth rate of chronic conditions, even among the non-elderly U.S. population, such estimates become increasingly important as cancer patients will likely have more comorbid conditions that will need to be managed, while the patients undergo potentially intensive cancer combination therapy involving surgery, chemotherapy and radiation (Imai, Gregg, Cheng, & Zhang, 2006;Partnership to Fight Chronic Diseases, 2009;Boyle, Thompson, Gregg, Barker, & Williamson, 2010). The higher rate of cancer complications and exacerbations of comorbid conditions among individuals with underlying comorbidities may explain this increase in the cost during the treatment phase, which can add significantly to the overall increasing cost of care (Srokowski, Fang, Hortobagyi, & Giordano, 2009;Peters et al, 2011;Lee, Cheung, Atkinson, & Krzyzanowska, 2011). It is also possible that individuals with underlying comorbidities are receiving additional services, because they are in contact with providers more often due to their cancer diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Impact of Chronic Conditions on the Cost of Cancer Care for Medicaid Beneficiaries

Subramanian¹,

Tangka²,

Sabatino³

et al. 2012

MMRR

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Background:No study has assessed the cost of treating adult Medicaid cancer patients with preexisting chronic conditions. This information is essential for understanding the cost of cancer care to the Medicaid program above that expended for other chronic conditions, given the increasing prevalence of chronic conditions among cancer patients. Research Design:We used administrative data from 3 state Medicaid programs' linked cancer registry data to estimate cost of care during the first 6 months following cancer diagnosis for beneficiaries with 4 preexisting chronic conditions: cardiac disease, respiratory diseases, diabetes, and mental health disorders. Our base cohort consisted of 6,212 Medicaid cancer patients aged 21 to 64 years (cancer diagnosed during [2001][2002][2003] who were continuously enrolled in fee-for-service Medicaid for 6 months after diagnosis. A subset of these patients who did not die during the 6-month follow-up (n=4,628), were matched with 2 non-cancer patients each (n=8,536) to assess incremental cost of care. Results:The average cost of care for cancer patients with the chronic conditions studied was higher than for cancer patients without any of these conditions. The increase in cancer treatment cost associated with the chronic conditions ranged from $4,385 for cardiac disease to $11,009 for mental health disorders. Conclusions:Chronic conditions, especially the presence of multiple conditions, are associated with a higher cost of care among Medicaid cancer patients, and these increased costs should be reflected in projections of future Medicaid cancer care costs. The implementation of better care-management processes for cancer patients with preexisting chronic conditions may be one way to reduce these costs.

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Section: Discussionmentioning

confidence: 99%

Impact of Chronic Conditions on the Cost of Cancer Care for Medicaid Beneficiaries

Subramanian¹,

Tangka²,

Sabatino³

et al. 2012

MMRR

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“…Wenn die älteren Patienten gut auf die Therapie eingestellt werden, so scheinen aber die Ergebnisse und die Komplikationsrate sowohl bei chirurgischer Behanldung als auch bei Radiotherapie nicht schlechter zu sein [53].…”

Section: Patientencharakteristikaunclassified

Larynxkarzinom

Pantel

Guntinas‐Lichius

2012

HNO

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Laryngeal cancer is one of the most frequent types of head and neck cancer. The incidence is decreasing for men but still increasing for women. The incidence in Germany is about 5-7/100,000 persons/year for men and 0.6-0.8/100,000 persons/year for women. Due to the increased life expectancy, the average age of patients diagnosed with laryngeal cancer is increasing. Nevertheless, adequately prepared older patients treated by standard protocols can have the same survival and complication rates as younger patients. Tobacco and alcohol are still the primary risk factors responsible for disease in at least 80% of the patients. Despite the many new diagnostic tools, still more than half of the patients are diagnosed at an advanced tumor stage. Survival rates have not improved significantly in the last 10 years in Germany, and the average 5-year overall survival rate is about 60%. However, a decrease in the survival rate, as observed in the USA, cannot be confirmed for Germany.

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“…Indeed, in our study, stage III and IV tumors at the time of presentation accounted for 67.2% of cases. Second, the risk of surgery increases in elderly persons, in correspondence with age-related increases in multiple chronic systemic diseases (Peters et al, 2011). Of the patients in our cohort, 77.9% had 1 or more comorbidities.…”

Section: Discussionmentioning

confidence: 78%

“…Various retrospective studies have shown that radical surgery can be performed safely in elderly patients in the absence of severe concomitant morbidities (Barzan et al, 1990;Kowalski et al, 1994;Clayman et al, 1998;Derks et al, 2003). However, several studies showed that complications of head and neck surgeries increased significantly in elderly patients, suggesting that standard treatments for laryngeal carcinoma are not suitable for elderly patients (Greenfield et al, 1987;Bhattacharyya and Fried, 2001;Peters et al, 2011). Because data on the survival of elderly patients with laryngeal carcinoma are limited and conflicting, otolaryngologists can be faced with therapeutic dilemmas.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of laryngectomy in elderly patients with laryngeal carcinoma

Shi¹,

Xu²,

Zhang³

et al. 2014

Genet. Mol. Res.

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ABSTRACT. Laryngeal carcinoma is a common tumor of the head and neck region. This study aimed to examine the outcomes of laryngectomy in elderly patients with laryngeal carcinoma. One-hundred twenty-two patients (male, 117; female, 5) aged 60 years or older (range, 60-94 years) who underwent laryngectomy between 1996 and 2010 were included. All patients were diagnosed with squamous cell carcinoma of the larynx, and 95 patients (77.9%) had additional concurrent diseases. III (pharyngeal fistula in 2 cases recovered after 2 weeks of care) wound healing. No significant differences were observed in the occurrence or severity of comorbidities. The 1-, 3-, and 5-year actuarial survival rates were 97.5% (119/122), 84.4% (92/109), and 68.4% (67/98), respectively. Age alone should not be used to determine treatment options for elderly patients with squamous cell carcinoma. Presuming that careful pre-treatment evaluations are performed, laryngectomy is a key method for elderly patients with laryngeal carcinoma.

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The impact of comorbidity on treatment-related side effects in older patients with laryngeal cancer

Cited by 42 publications

References 27 publications

Impact of Chronic Conditions on the Cost of Cancer Care for Medicaid Beneficiaries

Impact of Chronic Conditions on the Cost of Cancer Care for Medicaid Beneficiaries

Larynxkarzinom

Outcomes of laryngectomy in elderly patients with laryngeal carcinoma

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