ABSTRACT
OBJECTIVE: This study aimed to compare the prognostic impact of comorbidity grading by the Adult Comorbidity Evaluation 27 index and the Charlson Comorbidity Index on the five-year overall and disease-specific survival in patients undergoing surgery for laryngeal squamous cell carcinoma. METHODS: The impact of comorbidity and other factors on survival was examined retrospectively in a group of 177 patients with previously untreated tumour stage one to four laryngeal squamous cell carcinoma surgically treated at the Clinic of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, between 2000 and 2003. The Cox proportional hazard model was used to identify independent prognostic factors. RESULTS: On univariate analysis, comorbidity had an impact on prognosis regardless of which index was used. On multivariate analysis, the significant predictors of patients' five-year overall and disease-specific survival were tumour-node-metastasis stage and comorbidity as graded by the Adult Comorbidity Evaluation 27 index. CONCLUSION: The Adult Comorbidity Evaluation 27 index is a more reliable predictor of survival than the Charlson Comorbidity Index in patients with laryngeal squamous cell carcinoma.
Subject(s)
Carcinoma, Squamous Cell/epidemiology , Comorbidity , Health Status Indicators , Laryngeal Neoplasms/epidemiology , Adult , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/pathology , Female , Humans , Laryngeal Neoplasms/mortality , Laryngeal Neoplasms/pathology , Male , Middle Aged , Neoplasm Staging , Prognosis , Retrospective Studies , Severity of Illness Index , Survival AnalysisABSTRACT
The treatment of patients with supraglottic laryngeal cancer still remains a controversal issue. The study comprised 193 patients with a supraglottic laryngeal carcinoma treated in the period 1986-2003. All patients had primary surgery. They all had clinically and ultrasonografically negative findings in the neck (N0). Bilateral selective neck dissection at the level II-III was performed in all patients at the time of primar surgery. Postoperative radiotherapy was given to all patients with verified occult metastases (60 Gy). The occult cervical node metastases were found in 18% (35/193). Ipsilateral occult metastases were more common (77%, 27/35), but both bilateral and contralateral spread was also seen (14%, 5/35 and 9%, 3/35, respectively). Only in two (1%) did metastases develop subsequently. The 5-years survival rate was 86%.
