title: Importance of comorbidity in hypopharyngeal cancer.
abstract: BACKGROUND
  Comorbidity has an impact on survival in laryngeal cancer in several reports. However, the importance of comorbidity in hypopharyngeal cancer (HPC) has not been reported.
  
  
  METHODS
  A retrospective medical record review of 156 patients with HPC treated between 1995 and 2005 was performed. Comorbid illness was measured by the Adult Comorbidity Evaluation-27. A Cox proportional hazards model was used to determine the factors related to overall survival.
  
  
  RESULTS
  Comorbidity was absent in 55 (35.2%) of the patients, mild in 39 (25%), moderate in 28 (17.9%), and severe in 34 (21.8%). There were statistically significant differences between the survival rates in accord with age, stage, subsite, and comorbidity (45.1% for none or mild vs 27.7% for moderate or severe; p = .0073). Age, stage, and comorbidity were identified as independent prognostic factors in the multivariate analysis.
  
  
  CONCLUSIONS
  Comorbidity, along with the clinical stage, should be considered in treatment planning for patients with HPC.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan. ak-homma@med.hokudai.ac.jp
authors.forename: Akihiro
authors.initials: A
authors.lastname: Homma
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sakashita
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Oridate
authors.forename: Fumiyuki
authors.initials: F
authors.lastname: Suzuki
authors.forename: Seigo
authors.initials: S
authors.lastname: Suzuki
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hatakeyama
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Mizumachi
authors.forename: Shigenari
authors.initials: S
authors.lastname: Taki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fukuda
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate