Age-adjusted Charlson comorbidity index as a prognostic factor of hypopharyngeal cancer treated with chemoradiation therapy

Acta Otolaryngol. 2017 Jun;137(6):668-673. doi: 10.1080/00016489.2016.1269946. Epub 2017 Jan 13.

Abstract

Conclusion: The age-adjusted Charlson comorbidity index (ACCI) was associated with overall survival, disease-specific survival, and non-cancer death in patients treated with chemoradiation therapy (CRT) for hypopharyngeal cancer (HPC). Further studies using other CRT regimens are required.

Objective: To investigate the impact of the ACCI on survival in patients with HPC.

Methods: This study reviewed 128 patients with HPC who received CRT between 2004-2012. The survival rates and the cumulative incidence of non-cancer death according to the ACCI were estimated. A Cox proportional hazard model was used to assess the hazard ratio (HR) of the ACCI.

Results: The disease-specific survival rates at 3 years for the low ACCI group, moderate group, and high group were 80.1%, 45.8%, and 54.8%, respectively (p = 0.007). The laryngectomy-free survival rates at 3 years were 61%, 39.7%, and 37.1%, respectively (p = 0.137). The cumulative incidences of non-HPC death were 5% for the low/moderate ACCI group and 15.5% for the high ACCI group (p = 0.031). The HRs compared to the low ACCI group for overall survival, disease-specific survival, and laryngectomy-free survival were 2.61 and 2.74, 2.55 and 2.27, and 1.75 and 1.97 in the moderate and high ACCI groups, respectively.

Keywords: Hypopharynx; chemotherapy; head and neck; radiation; squamous cell cancer.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / therapy*
  • Cause of Death
  • Comorbidity
  • Female
  • Humans
  • Hypopharyngeal Neoplasms / diagnosis
  • Hypopharyngeal Neoplasms / mortality
  • Hypopharyngeal Neoplasms / therapy*
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies