The prognostic role of comorbidity in salivary gland carcinoma

Abstract

BACKGROUND.Patients with head and neck cancer are prone to develop significant comorbidity mainly because of the high incidence of tobacco and alcohol abuse, both of which are etiologic and prognostic factors. However, to the authors' knowledge little is known regarding the prognostic relevance of comorbidity in patients with salivary gland cancer.METHODS.A retrospective cohort of 666 patients with salivary gland cancer was identified within the Dutch Head and Neck Oncology Cooperative Group database. For multivariate analysis, a Cox proportional hazards model was used to study the effect of comorbidity on overall survival and disease‐specific survival.RESULTS.According to the Adult Comorbidity Evaluation‐27 (ACE‐27) index, 394 patients (64%) had grade 0 comorbidity, 119 patients (19%) had grade 1 comorbidity, 71 patients (12%) had grade 2 comorbidity, and 29 patients (5%) had grade 3 comorbidity. In multivariate analysis for overall survival, the ACE‐27 comorbidity grade was a strong independent prognostic variable. The hazards ratio (HR) of death, including all causes, was 1.5 (95% confidence interval [CI], 1.1‐2.1) for patients with ACE‐27 grade 1 comorbidity versus grade 0 comorbidity (P < .007). The HR was 1.7 (95% CI, 1.2‐2.5) for grade 2 comorbidity (P = .003) and 2.7 (95% CI, 1.5‐4.7) for grade 3 comorbidity versus grade 0 comorbidity (P = .001). In the current analysis, ACE‐27 comorbidity grade was not an independent prognostic factor for disease‐free survival.CONCLUSIONS.To the authors' knowledge, this is the first study concerning the prevalence and relevance of the prognostic comorbidity variable ACE‐27 grade in patients with salivary gland cancer. Overall survival, but not disease‐free survival, was correlated strongly with ACE‐27 grade. Compared with other studies that investigated the effect of comorbidity on patients with head and neck cancer, patients with salivary gland cancer had less comorbidity. Their comorbid status appeared to be reasonably comparable to that of patients with other nonsmoking‐ and nonalcohol‐related cancers. Cancer 2008. © 2008 American Cancer Society.

Nomograms for predicting long-term overall survival and cancer-specific survival in patients with major salivary gland cancer: a population-based study

“…In the present study, several clinical and pathologic characteristics were shown to be independent prognostic factors for OS and CSS in patients with MSGC, including age, sex, tumor site, tumor grade, surgery performed, radiation therapy, and TNM classifications, which is consistent with previous reports [5, 6, 8, 11, 27–30]. Apart from these, comorbidity and postoperative complications, which were not included in the present study, have been proven to be accurate prognostic factors [11, 30].…”

Treatment of Parotid Malignancies—10 Years of Experience

“…19 Factors that statistically shorten survival included high T stage, highgrade malignancy, and FN paralysis on diagnosis. 1 According to Terhaard et al, 20 the most important independent factors negatively affecting survival rate include young age, high T and N stages, skin infiltration, and male gender. However, Takahama et al 21 did not observe any relation between these variables and overall survival.…”

A Comprehensive Analysis of Parotid and Salivary Gland Cancer: Worse Outcomes for Male Gender

“…A recent multivariate analysis for overall survival in salivary gland malignancies showed that patient comorbidity was a strong independent prognostic variable [14]. Results of the multivariate analysis using the Cox regression model, including patient comorbidities as categorical variables, are summarized in Table 4.…”