Sarah Schimansky1, Samantha Lang1, Rhona Beynon2, Christopher Penfold1, Amy Davies1, Andrea Waylen3, Steve Thomas3, Miranda Pring3, Michael Pawlita4, Tim Waterboer5, Andy Ness1. 1. National Institute of Health (NIHR) Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, Bristol, United Kingdom. 2. Department of Population Health Sciences, University of Bristol Medical School, Bristol, United Kingdom. 3. Department of Oral and Dental Sciences, Bristol Dental School, Bristol, United Kingdom. 4. Molecular Diagnostics of Oncogenic Infections Division, German Cancer Research Center (DKFZ), Heidelberg, Germany. 5. Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
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.
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.
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