Impact of comorbidities and lifestyle factors on treatment outcomes in patients with laryngeal cancer - a single institution retrospective review
Abstract
Background: Surgical approaches that preserve laryngeal function are the mainstay of treatment for early-stage laryngeal cancer. In advanced stages, total laryngectomy is associated with a significant mutilation of the patient and (chemo)radiotherapy may provide an organ-preserving treatment. The aim of this report is to present the influence of comorbidities and lifestyle factors on treatment outcomes in a cohort of patients irradiated for laryngeal cancer at the Institute of Radiation Oncology of Bulovka University Hospital (IRO FNB), Prague, Czech Republic, in the years 2009-2018.
Patients and methods: During this period, curative radiotherapy for laryngeal cancer was performed in 189 patients at the IRO FNB. Concomitant chemotherapy (cisplatin once weekly) was added in 48 (25.4%) patients.
Results: The median follow-up was 38.1 months, median progression free survival was 17.8 months. Disease persistence or recurrence was confirmed in 59 (31.2%) patients. There was a significant effect of comorbidities and lifestyle factors on treatment outcomes. The most important influence is the baseline PS (performance status) and baseline haemoglobin values: patients in good condition or without anaemia at baseline showed significantly longer survival compared to patients in poor condition or with anaemia. The comorbidities according to the Charlson Comorbidity Index and the ACE-27 system were a significant predictor of overall survival. Abuse of more alcohol had a significant effect on worse outcomes.
Conclusion: In our cohort of patients with laryngeal cancer, a good therapeutic effect was achieved with (chemo)radiotherapy. Statistically significant effects on overall survival were found for baseline PS, haemoglobin level, associated comorbidities and history of alcohol abuse.