The impact of comorbidity on treatment-related side effects in older patients with laryngeal cancer.

The standard treatment of elderly head and neck patients is controversial. The goal of this study was to evaluate the relationship between co-morbidity and complications in elderly laryngeal cancer patients treated with different modalities. Retrospective analysis of patients 75 years old and older with laryngeal cancer (n=139) and patients 65 years old and younger as a reference control group (n=289) diagnosed in our department between 1997 and 2007 has been performed. Pretreatment co-morbidity (ACE-27), treatment-related complications and one- and six-month death rates have been analyzed. Co-morbidity rate was more pronounced in the elderly group, but did not result in more complications. Correlation has been found between co-morbidity and complication in the whole patients group, but not in the elderly group. By multivariate analysis, in all age groups radiation therapy (vs. total laryngectomy) and tumor stage were predictors of complications but co-morbidity and age were not. According to our study there is no reason to treat elderly laryngeal cancer patients differently. The weaker relation between co-morbidity and complications emphasizes the importance of careful pre-treatment evaluation in elderly.