Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
Head Neck. 2018 Sep;40(9):2060-2069. doi: 10.1002/hed.25200. Epub 2018 May 13.
The purpose of this study was to quantify the relationship among age, pretreatment comorbidity, and survival outcomes in patients with locally advanced laryngeal cancer.
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.
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).
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.
本研究旨在定量评估局部晚期喉癌患者的年龄、预处理合并症与生存结局之间的关系。
收集基线合并症数据，并计算每位患者的年龄调整 Charlson 合并症指数（CCI）。采用 Kaplan-Meier 和 Cox 比例风险模型来确定与生存的关联。
本研究纳入了 548 例患者，中位年龄为 59 岁（范围 31-91 岁），58%的患者接受了喉保留治疗，其余患者接受了全喉切除术和辅助放疗（RT）。238 例（43%）患者至少存在 1 种合并症。心血管疾病是最常见的合并症（19%）。CCI≤3（n=442）的患者 5 年总生存率（OS）优于 CCI>3（n=106；60% vs 41%；P<0.0001），尽管 5 年疾病特异性生存率（DSS）无显著差异。CCI≤3 的患者 5 年非癌症 CSS 更好（88% vs 67%；P<0.0001）。
年龄调整的 CCI 是局部晚期喉癌患者非癌症 CSS 和 OS 的重要预测指标，但与 DSS 无关。
