Association between comorbidity and survival in head and neck cancer: Results from Head and Neck 5000

Head Neck. 2019 Apr;41(4):1053-1062. doi: 10.1002/hed.25543. Epub 2018 Dec 14.

Abstract

Background: People with head and neck cancer have higher comorbidity levels but it remains unclear if pretreatment comorbidity is an independent prognosticator in head and neck cancer.

Methods: Survival analyses were performed using data from participants in a UK multicentre cohort study with cancers of the oral cavity (n = 668), oropharynx (n = 1074), and larynx (n = 530). Survival analyses were incrementally adjusted for age, sex, marital status, income, education, stage, alcohol, and smoking.

Results: After adjusting for demographic, clinical, and behavioral confounders, higher baseline comorbidity was associated with reduced overall survival (mild comorbidity HR = 1.4, 95% CI = 1.1, 1.7; moderate comorbidity HR = 1.7, 95% CI = 1.3, 2.2; severe comorbidity HR = 2.8, 95% CI = 1.9, 4.; P-trend<.001).

Conclusions: Our findings suggest that comorbidity is an independent prognosticator for overall survival in head and neck cancer. Comorbid illnesses should be considered in the assessment and treatment planning of people with head and neck cancer.

Keywords: ACE 27; comorbidity; head and neck cancer; human papillomavirus; survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / therapy
  • Cause of Death
  • Cohort Studies
  • Comorbidity*
  • Databases, Factual
  • Female
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / therapy
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Sex Distribution
  • United Kingdom