[The ASA-score as a comorbidity index in patients with cancer of the oral cavity and oropharynx].
BACKGROUND
The American Society of Anesthesiologists Physical Status Scores (ASA-Score) may serve as a valuable indicator of comorbidity in head and neck cancer patients.


METHODS
In 135 patients with squamous cell carcinoma of the oral cavity and/or oropharynx, the relation of disease free and overall survival and the ASA-score was evaluated in a univariate (logrank-test) and a Cox regression model. In the Cox model, age, tumor site and stage, and therapeutic modality served as covariates.


RESULTS
In the univariate model, overall 5 year survival in ASA I and II patients was 44 %, and in ASA III and IV patients, it was 16 % (p < 0.005). The ASA-score also significantly influenced survival in the multivariate model. The hazard ratio (ASA I and II vs. ASA III and IV) was 2.1 (95 % confidence interval 1.3 to 3.4; p < 0,005). This corresponds to a 8 times higher risk to die, even when the effects of age, tumor site and stage, and therapeutic modalities are compensated for.


CONCLUSIONS
The ASA-score is a valuable indicator of comorbidity in patients with oral cavity and oropharyngeal tumors. An essential advantage is its easy availability in most clinical settings.
Universitäts-HNO-Klinik Ulm. herbert.riechelmann@medizin.uni-ulm.de
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H
Riechelmann
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A
Neagos
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Netzer-Yilmaz
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Gronau
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M
Scheithauer
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MG
Rockemann
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000473:pathology; D009062:Mouth Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D009960:Oropharynx / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors