title: The impact of comorbidity on the survival of patients with laryngeal squamous cell carcinoma.
abstract: Abstract Conclusions: In survival analysis, the combined Charlson comorbidity index (CCI) can be considered as a prognostic factor independent of the tumor node metastasis (TNM) classification, tumor stage, and tumor location. Severe comorbidity was the factor that had the greatest impact on prognosis in cases of initial tumor.
  
  
  OBJECTIVE
  To study the influence of comorbidity on the survival of patients undergoing surgery for larynx cancer.
  
  
  METHODS
  This was a retrospective study of the survival of 231 patients with laryngeal cancer who underwent surgery between 1995 and 2002. The CCI was used to assess comorbidity, the Kaplan-Meier method was used for survival analysis, and the Cox proportional risk regression model was used to identify independent prognostic factors.
  
  
  RESULTS
  The multivariate analysis of specific mortality showed that patients classified as having severe comorbidity (CCI) were more likely to die (adjusted hazard ratio (adjHR) 1.85, 95% confidence interval (CI) 1.07-3.17). This difference was more important in patients with early tumor stages than in those with advanced stages.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Hospital Clínico San Carlos, C/ Profesor Martín Lagos s/n, Madrid, Spain.
authors.forename: Jesus
authors.initials: J
authors.lastname: Gimeno-Hernández
authors.forename: Mari-Cruz
authors.initials: MC
authors.lastname: Iglesias-Moreno
authors.forename: Manuel
authors.initials: M
authors.lastname: Gómez-Serrano
authors.forename: Francisco
authors.initials: F
authors.lastname: Carricondo
authors.forename: Pablo
authors.initials: P
authors.lastname: Gil-Loyzaga
authors.forename: Joaquin
authors.initials: J
authors.lastname: Poch-Broto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology; D015897:Comorbidity / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors