Comorbidity as predictor poor prognosis for patients with advanced head and neck cancer treated with major surgery

Abstract

Background: The impact of comorbidities on patients with advanced head and neck cancer treated with major surgery has not been reported before.

Methods: We retrospectively reviewed clinical charts between 2004 and 2011 at our institution and identified 185 patients with clinical stage III to IV head and neck cancer treated with major surgery. Comorbidities were scored using the Adult Comorbidity Evaluation-27 (ACE-27) index manual.

Results: Patients with ACE-27 ≥2 had significantly worse overall survival (OS) and disease-specific survival (DSS) than those with ACE-27 ≤1 (p < .0001 and p = .0047, respectively). Multivariate analyses revealed that ACE-27 ≥2 and extracapsular spread (ECS) were independently significant adverse prognostic factors for OS and DSS. In addition, patients with ACE-27 ≥2 had a higher incidence of distant metastases (p = .0057).

Conclusion: The current study suggests that comorbidities may predict poor prognosis and development of distant metastases for patients with advanced head and neck cancer treated with major surgery.

Keywords: Adult Comorbidity Index-27 (ACE-27); advanced head and neck cancer; comorbidity; prognostic factor; radical surgery.