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

• Published in: Head & neck Vol. 41; no. 4; pp. 1053 - 1062
• Main Authors: Schimansky, Sarah, Lang, Samantha, Beynon, Rhona, Penfold, Christopher, Davies, Amy, Waylen, Andrea, Thomas, Steve, Pring, Miranda, Pawlita, Michael, Waterboer, Tim, Ness, Andy
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.04.2019; Wiley Subscription Services, Inc
• Subjects: ACE 27; Adult; Age Distribution; Aged; Cancer; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - therapy; Cause of Death; Cohort Studies; Comorbidity; Databases, Factual; Female; Head & neck cancer; head and neck cancer; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - therapy; human papillomavirus; Humans; Incidence; Kaplan-Meier Estimate; Larynx; Male; Middle Aged; Oral cavity; Oropharynx; Outcome Assessment, Health Care; Proportional Hazards Models; Retrospective Studies; Risk Assessment; Sex Distribution; Smoking; Survival; United Kingdom; United Kingdom; ACE 27; comorbidity; head and neck cancer; human papillomavirus; survival
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.25543

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.