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Comorbidity and prognosis in head and neck cancers: Differences by subsite, stage, and human papillomavirus status.
Habbous, Steven; Harland, Luke T G; La Delfa, Anthony; Fadhel, Ehab; Xu, Wei; Liu, Fei-Fei; Goldstein, David; Waldron, John; Huang, Shao-Hui; O'Sullivan, Brian; Liu, Geoffrey.
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  • Habbous S; Department of Medicine, Medical Biophysics, and Epidemiology, Ontario Cancer Institute, Princess Margaret Hospital/University Health Network, Toronto, Ontario, Canada; Department of Biostatistics, Princess Margaret Hospital, Toronto, Ontario, Canada.
Head Neck ; 36(6): 802-10, 2014 Jun.
Article en En | MEDLINE | ID: mdl-23616414
BACKGROUND: The prognostic utility of comorbidity on head and neck cancer may differ by subsite, stage, and human papillomavirus (HPV) status. METHODS: We reviewed the medical records of 4953 patients with head and neck cancer for comorbidity (Charlson Comorbidity Index [CCI]), smoking, and alcohol history. Multivariate proportional hazards assessed the association of CCI with survival. HPV status was determined using p16 immunohistochemistry. RESULTS: After accounting for stage, higher CCI was associated with worse overall survival (OS) in nasopharyngeal (hazard ratio [HR], 2.93; 95% confidence interval [CI], 1.53-5.62), oropharyngeal (HR, 1.99; 95% CI, 1.63-2.43), and oral cavity cancers (HR, 1.54; 95% CI, 1.27-1.86). These associations were most prominent in the early stage oral cavity (HR, 2.11; 95% CI, 1.50-2.96) and laryngeal (HR, 1.87; 95% CI, 1.35-2.58) cancers, and in advanced stage oropharyngeal (HR, 2.23; 95% CI, 1.81-2.74) and nasopharyngeal (HR, 3.50; 95% CI, 1.76-6.97) cancers. CCI was independently prognostic even in the HPV-adjusted oropharyngeal cancers. CONCLUSION: Comorbidity was prognostic in subsets of nasopharyngeal, oropharyngeal, oral cavity, and laryngeal cancers. Comorbidity may be a partial surrogate for age and social habits.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Células Escamosas / Infecciones por Papillomavirus / Neoplasias de Cabeza y Cuello Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Head Neck Asunto de la revista: NEOPLASIAS Año: 2014 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Células Escamosas / Infecciones por Papillomavirus / Neoplasias de Cabeza y Cuello Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Head Neck Asunto de la revista: NEOPLASIAS Año: 2014 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos