دورية أكاديمية
Comorbidity in head and neck cancer: Is it associated with therapeutic delay, post-treatment mortality and survival in a population-based study?
| العنوان: | Comorbidity in head and neck cancer: Is it associated with therapeutic delay, post-treatment mortality and survival in a population-based study? |
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| المؤلفون: | Stordeur, Sabine, Schillemans, Viki, Savoye, Isabelle, Vanschoenbeek, Katrijn, Leroy, Roos, Macq, Gilles, Verleye, Leen, De Gendt, Cindy, Nuyts, Sandra, Vermorken, Jan, Beguin, Claire, Grégoire, Vincent, Van Eycken, Liesbet |
| المساهمون: | UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service de radiothérapie oncologique |
| المصدر: | Oral oncology, Vol. 102, p. 104561 (2020) |
| بيانات النشر: | Elsevier |
| سنة النشر: | 2020 |
| المجموعة: | DIAL@USL-B (Université Saint-Louis, Bruxelles) |
| مصطلحات موضوعية: | Adult, Aged, 80 and over, Comorbidity, Female, Head and Neck Neoplasms, Humans, Kaplan-Meier Estimate, Logistic Models, Male, Middle Aged, Mouth Neoplasms, Postoperative Period, Squamous Cell Carcinoma of Head and Neck, Statistics, Nonparametric, Time-to-Treatment, Charlson comorbidity index, Head and neck cancer, Mortality, Performance status, Population-based study, Survival |
| الوصف: | OBJECTIVES: This study aims to investigate the relationship between comorbidities and therapeutic delay, post-treatment mortality, overall and relative survival in patients diagnosed with squamous cell carcinoma of the head and neck (HNSCC). PATIENTS AND METHODS: 9245 patients with a single HNSCC diagnosed between 2009 and 2014 were identified in the Belgian Cancer Registry. The Charlson Comorbidity Index (CCI) was calculated for 8812 patients (95.3%), distinguishing patients having none (0), mild (1-2), moderate (3-4) or severe comorbidity (>4). The relationship between CCI and therapeutic delay was evaluated using the Spearman correlation. Post-treatment mortality was modelled with logistic regression, using death within 30 days as the event. The association between comorbidity and survival was assessed using Cox proportional hazard models. RESULTS: Among 8812 patients with a known CCI, 39.2% had at least one comorbidity. Therapeutic delay increased from 31 to 36 days when the CCI worsened from 0 to 4 (rho = 0.087). After case-mix adjustment, higher baseline comorbidity was associated with increased post-surgery mortality (mild, OR 3.52 [95% CI 1.91-6.49]; severe, OR 18.71 [95% CI 6.85-51.12]) and post-radiotherapy mortality (mild, OR 2.23 [95% CI 1.56-3.19]; severe, OR 9.33 [95% CI 4.83-18.01]) and with reduced overall survival (mild, HR 1.39, [95% CI 1.31-1.48]; severe, HR 2.41 [95% CI 2.00-2.90]). That was also the case for relative survival in unadjusted analyses (mild, EHR 1.77 [95% CI 1.64-1.92]; severe, EHR = 4.15 [95% CI 3.43-5.02]). CONCLUSION: Comorbidity is significantly related to therapeutic delay, post-treatment mortality, 5-year overall and relative survival in HNSCC patients. Therapeutic decision support tools should optimally integrate comorbidity. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1368-8375 1879-0593 |
| العلاقة: | boreal:250376; http://hdl.handle.net/2078.1/250376Test; info:pmid/31918175; urn:ISSN:1368-8375; urn:EISSN:1879-0593 |
| DOI: | 10.1016/j.oraloncology.2019.104561 |
| الإتاحة: | https://doi.org/10.1016/j.oraloncology.2019.104561Test http://hdl.handle.net/2078.1/250376Test |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.23B868C5 |
| قاعدة البيانات: | BASE |
| تدمد: | 13688375 18790593 |
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| DOI: | 10.1016/j.oraloncology.2019.104561 |