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合并症是老年头颈癌患者的一个预后因素。

Comorbidity is a prognostic factor in elderly patients with head and neck cancer.

作者信息

Sanabria Alvaro, Carvalho André Lopes, Vartanian José Guilherme, Magrin José, Ikeda Mauro Kasuo, Kowalski Luiz Paulo

机构信息

Department of Head and Neck Surgery and Otorhinolaringology, Hospital do Câncer AC Camargo, Fundação Antonio Prudente, São Paulo, Brazil.

出版信息

Ann Surg Oncol. 2007 Apr;14(4):1449-57. doi: 10.1245/s10434-006-9296-1. Epub 2007 Jan 18.

Abstract

BACKGROUND

The number of aged patients with head and neck cancer is increasing. Comorbidities are common in this population. It is necessary to evaluate the effect of comorbidities as measured with the ACE-27 index on recurrence and survival of elderly patients with head and neck cancer, adjusting by other prognostic factors as age, clinical stage and functional status index.

PATIENTS

Three hundred and ten patients greater than 70 years of age with head and neck cancer in a referral cancer center were studied. Comorbidity measured with the ACE-27 index was the main independent variable. The outcomes were recurrence and survival.

RESULTS

Comorbidities were present in 75% of patients. Five-year disease-free survival, overall survival and cancer-specific survival were 63.1, 42.8 and 55.8%, respectively. Advanced clinical stage and Karnofsky index < or =70 were associated with recurrence. Age >80 years, male gender, Karnofsky index < or =80, advanced clinical stage, and ACE value > or =2 were independently associated with overall survival. The ACE-27 value was not associated with cancer-specific survival. The Karnofsky performance index was associated with overall survival and mortality and acted as a confounding factor on multivariable analysis on overall and cancer-specific survival.

CONCLUSIONS

Comorbidity measured with ACE-27 was a prognostic factor for overall survival in patients older than 70 years with head and neck cancer. The Karnofsky performance index could be included in multivariable analysis of survival for older patients with head and neck cancer.

摘要

背景

老年头颈癌患者数量正在增加。该人群中合并症很常见。有必要评估以ACE - 27指数衡量的合并症对老年头颈癌患者复发和生存的影响,并根据年龄、临床分期和功能状态指数等其他预后因素进行调整。

患者

对一家转诊癌症中心的310名年龄大于70岁的头颈癌患者进行了研究。以ACE - 27指数衡量的合并症是主要自变量。观察结果为复发和生存情况。

结果

75%的患者存在合并症。5年无病生存率、总生存率和癌症特异性生存率分别为63.1%、42.8%和55.8%。临床分期较晚和卡诺夫斯基指数≤70与复发相关。年龄>80岁、男性、卡诺夫斯基指数≤80、临床分期较晚以及ACE值≥2与总生存率独立相关。ACE - 27值与癌症特异性生存率无关。卡诺夫斯基表现指数与总生存率和死亡率相关,并且在总生存率和癌症特异性生存率的多变量分析中是一个混杂因素。

结论

以ACE - 27衡量的合并症是70岁以上头颈癌患者总生存的一个预后因素。卡诺夫斯基表现指数可纳入老年头颈癌患者生存情况的多变量分析中。

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