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Association between comorbidity and survival in head and neck cancer: Results from Head and Neck 5000
Author(s) -
Schimansky Sarah,
Lang Samantha,
Bey Rhona,
Penfold Christopher,
Davies Amy,
Waylen Andrea,
Thomas Steve,
Pring Miranda,
Pawlita Michael,
Waterboer Tim,
Ness Andy
Publication year - 2019
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25543
Subject(s) - comorbidity , medicine , head and neck cancer , confounding , cancer , oncology
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.