Age-adjusted comorbidity and survival in locally advanced laryngeal cancer

Head Neck. 2018 Sep;40(9):2060-2069. doi: 10.1002/hed.25200. Epub 2018 May 13.

Abstract

Background: The purpose of this study was to quantify the relationship among age, pretreatment comorbidity, and survival outcomes in patients with locally advanced laryngeal cancer.

Methods: Baseline comorbidity data were collected and age-adjusted Charlson Comorbidity Index (CCI) was calculated for each case. Kaplan-Meier and Cox proportional hazards modeling were used to determine associations with survival.

Results: For 548 patients, with a median age of 59 years (range 31-91 years), 58% were treated with larynx preservation and the rest with total laryngectomy and adjuvant radiotherapy (RT). Two hundred thirty-eight patients (43%) had at least 1 comorbidity each. Cardiovascular diseases were the most common comorbidities (19%). The 5-year overall survival (OS) for patients with CCI ≤3 (n = 442) were superior to CCI >3 (n = 106; 60% vs 41%; P < .0001), although the 5-year disease-specific survival (DSS) rates were not significantly different. The 5-year noncancer CSS was better for age-adjusted CCI ≤3 (88% vs 67%; P < .0001).

Conclusion: The age-adjusted CCI is a significant predictor of noncancer CSS and OS for patients with locally advanced laryngeal cancer but is not associated with DSS.

Keywords: age; comorbidity; head and neck cancer; larynx cancer; radiotherapy; survival outcomes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Disease-Free Survival
  • Female
  • Humans
  • Laryngeal Neoplasms / complications*
  • Laryngeal Neoplasms / mortality*
  • Laryngeal Neoplasms / pathology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Survival Rate