Impact of comorbidity and harmful habits on treatment success in patients with laryngeal cancer

• Published in: Zdravniški vestnik (Ljubljana, Slovenia : 1992) Slovenia : 1992), 2007-04, Vol.76 (4)
• Main Authors: Peter Pukl, Irena Hočevar-Boltežar, Lojze Šmid
• Format: Article
• Language: English
• Subjects: comorbidity; excessive alcohol intake; laryngeal cancer; smoking; squamous cell carcinoma; survival rate
• ISSN: 1318-0347; 1581-0224

Background: Survival of the patients with head and neck cancer is affected by the tumor stage and also by comorbidity. The aim of the study was to evaluate the impact of comorbidity (respiratory, cardiovascular, gastrointestinal, neurological and systemic diseases) and harmful habits on treatment results of laryngeal cancer.Methods: Eighty-nine patients with squamous cell carcinoma of the larynx (92 % men) who had been surgically treated at the University Department of Otorhinolaryngology and Cervicofacial Surgery in Ljubljana between January 1, 1996 and December 31, 1998 have been included into the retrospective study. Most of the patients were treated with radiotherapy or chemotherapy for the same cancer at the Institute of Oncology in Ljubljana. The medical data were obtained from medical hospital records, the data of Slovene Registry of Cancer and the Slovene Institute for Health Care.Results: The mean age of the patients was 59.5 years. There were only 4 % of non-smokers in the studied population. In 33 % of patients excessive consumption of alcohol was documented. In 84 % of all patients at least one comorbidity was detected. Fifty-four percent of them had pulmonary, 39 % cardiovascular, 26 % systemic, 25 % gastrointestinal, and 3 % neurological diseases. Significantly shorter 5-year survival was found in patients with an advanced tumour (p = 0.002 ÷2), neck metastases (p = 0.000 ÷2), and advanced age (0.042 ÷2). The results of the study presented a significant impact of alcohol consumption on survival of our patients (p = 0.014 ÷2). The comorbidity was detected more often in patients with excessive alcohol consumption (p = 0.046 ÷2) and in older patients (0.018 ÷2). The anaesthesiologist’s assessment of the patients’ health status also influenced their 5-year survival (p = 0.014 [Fisher exact]).Conclusions: Comorbidity, which can be a result of harmful habits, is very often found in laryngeal cancer patients. A significantly shorter survival was connected with advanced tumour stage, advanced age, worse anaesthesiologist’s assessment before surgery and excessive alcohol consumption. No significant direct impact of comorbidity on survival was detected. The influence of comorbidity on the patients’ survival could be indirect because more comorbidities were found in older patients and in those with excessive alcohol intake. The comorbidity also influenced the anaesthesiologist’s assessment of the patients’ health status.