Age-adjusted Comorbidity Predicts Survival in Laryngeal Cancer
Age and pretreatment comorbidities were shown to impact survival outcomes in patients with locally advanced laryngeal cancer.
A retrospective study showed age and pretreatment comorbidities influence survival outcomes in patients with locally advanced laryngeal cancer.1 The study findings were published in Head & Neck.
To conduct the study, researchers reviewed electronic and paper medical records for patients who received a diagnosis of laryngeal squamous cell carcinoma between 1985 and 2011. Eligible individuals had previously untreated locally advanced disease. Records from 548 cases were included in the analysis. For each case, baseline comorbidity data were gathered to calculate the age-adjusted Charlson Comorbidity Index (CCI).
For the study group, the median age was 59 years (range, 31-91), most were smokers (95%), and more than half (58%) were treated with larynx preservation; the rest underwent total laryngectomy and adjuvant radiotherapy. Fewer than half of the patients (43%) had 1 or more comorbidities, with cardiovascular diseases being the most common (19%).
Patients with age-adjusted CCI less than or equal to 3 had better 5-year overall survival (OS) compared with patients with CCI greater than 3 (60% vs 41%; P < .0001). The difference between 5-year disease-specific survival rates, however, did not reach statistical significance. Patients with age-adjusted CCI less than 3 had improved 5-year noncancer cause-specific survival (CSS) (88% vs 67%; P < .0001). Taken together, the results suggested age-adjusted CCI could be a predictor of noncancer CSS and OS.
“These findings demonstrate, not surprisingly, that older patients with more comorbidities who present before the initiation of therapy do worse in terms of OS and death from noncancer causes when compared with their counterparts,” the study authors wrote.
- Multidisciplinary Larynx Cancer Working Group; Mulcahy CF, Mohamed ASR, et al. Age-adjusted comorbidity and survival in locally advanced laryngeal cancer. Head Neck. 2018;40(9):2060-2069.