Alho Olli-Pekka, Hannula Kalle, Luokkala Antti, Teppo Heikki, Koivunen Petri, Kantola Saara
Department of Otorhinolaryngology, University of Oulu, P.O. Box 5000, Oulu FIN-90014, Finland.
Head Neck. 2007 Oct;29(10):913-8. doi: 10.1002/hed.20608.
The aim was to investigate how the effect of comorbid illnesses on survival is modified by other prognostic factors in head and neck cancer.
A population-based retrospective cohort study involved 221 patients residing in 1 primary health care district (population about 700,000) in whom head and neck carcinoma was diagnosed between January 1, 1986, and December 31, 1996. Data on clinical characteristics and survival were obtained from patient charts. Comorbidity was classified according to Charlson score.
At 3 years, the risk of death was significantly higher among the patients with high comorbidity status (score 3 or higher) (adjusted hazard ratio 2.1, 95% confidence interval 1.2-3.7). The excess risk associated with comorbidity, however, was confined to the subjects aged under 65 years and those with tongue or laryngeal tumors or stage I-II cancer.
To assess the prognostic significance of comorbidity for an individual patient with head and neck cancer, age, tumor site, and cancer stage must be considered.
目的是研究合并症对生存的影响如何被头颈癌的其他预后因素所改变。
一项基于人群的回顾性队列研究纳入了居住在1个初级卫生保健区（人口约70万）的221例患者，这些患者在1986年1月1日至1996年12月31日期间被诊断为头颈癌。临床特征和生存数据来自患者病历。合并症根据Charlson评分进行分类。
3年时，合并症状态高（评分3或更高）的患者死亡风险显著更高（调整后风险比2.1，95%置信区间1.2 - 3.7）。然而，与合并症相关的额外风险仅限于65岁以下的受试者、患有舌癌或喉癌的患者或I - II期癌症患者。
为评估合并症对个体头颈癌患者的预后意义，必须考虑年龄、肿瘤部位和癌症分期。
