Journal
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
Volume 41, Issue 4, Pages 1053-1062Publisher
WILEY
DOI: 10.1002/hed.25543
Keywords
ACE 27; comorbidity; head and neck cancer; human papillomavirus; survival
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Funding
- Cancer Research UK [C18281/A19169]
- Programme Grants for Applied Research [RP-PG-0707-10034]
- Wellcome Trust [110021/z/15/A]
- Wellcome Trust [110021/Z/15/A] Funding Source: Wellcome Trust
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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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