Measuring Comorbidity in Patients With Head and Neck Cancer
Article first published online: 2 JAN 2009
Copyright © 2002 The Triological Society
Volume 112, Issue 11, pages 1988–1996, November 2002
How to Cite
Hall, S. F., Rochon, P. A., Streiner, D. L., Paszat, L. F., Groome, P. A. and Rohland, S. L. (2002), Measuring Comorbidity in Patients With Head and Neck Cancer. The Laryngoscope, 112: 1988–1996. doi: 10.1097/00005537-200211000-00015
- Issue published online: 2 JAN 2009
- Article first published online: 2 JAN 2009
- Manuscript Accepted: 7 SEP 2002
- head and neck cancer
Background Comorbidities are diseases or conditions that coexist with a disease of interest. The importance of comorbidities is that they can alter treatment decisions, change resource utilization, and confound the results of survival analysis.
Objective The objective of this study was to determine the best comorbidity index to use in survival analysis of patients with squamous cell carcinoma of the head and neck.
Method Four validated indexes, with very different methodologies (i.e., the Charlson Index, the Cumulative Illness Rating Scale, the Kaplan-Feinstein Classification, the Index of Co-existent Disease), were tested using data from 379 unselected consecutive patients with complete 3-year follow-up from the Kingston Regional Cancer Center. Kaplan-Meier analysis and Cox Proportional Hazards Regression were used to stratify patients into three levels of increasing severity of comorbidity for each index. The Proportion of Variance Explained and Receiver Operating Characteristics curves were used to compare the performance of the indexes.
Conclusion The Kaplan-Feinstein Classification was the most successful in stratifying patients in this population.