title: Prognostic value of comorbidities in patients with carcinoma of the major salivary glands.
abstract: This study aimed at evaluating the influence of comorbidities on outcome and survival in patients with carcinoma of the major salivary glands. Medical records of 109 patients with carcinoma of the major salivary glands treated at a single quaternary medical care and cancer center between 2003 and 2015 were reviewed. Comorbidities were classified according to the Age-Adjusted Charlson Comorbidity Index (ACCI) scoring system. 59 patients were males, 50 were females. Median age was 69 years and the median interval between tumor diagnosis and date of study inclusion was 71 months. Most carcinoma arose in the parotid gland (90 patients), and most patients presented with T 1 (25) or T 2 (37) cancer. Mean ACCI score was 2.9, and the most frequent ACCI score was 4. Mean overall survival was 119 months (ACCI 0-3) and 55 months (ACCI score >4), respectively (p = 0.005). Mean disease-free survival (ACCI 0-3) was 110 and 58 months (ACCI > 4), respectively (p = 0.02). Survival was significantly improved in low grade tumors, lower T and UICC stage and lymph node-negative patients. Sex, age, history of smoking and resection margins had no influence on overall survival. High comorbidity is an independent risk factor on overall and disease-free survival in patients with major salivary gland carcinoma. This is the first study evaluating comorbidity using the ACCI scoring system in this group of patients.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Centre Freiburg, Killianstrasse 5, 79106, Freiburg, Germany. christoph.becker@uniklinik-freiburg.de.
authors.forename: Christoph
authors.identifier: http://orcid.org/0000-0002-8385-0785
authors.initials: C
authors.lastname: Becker
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Centre Freiburg, Killianstrasse 5, 79106, Freiburg, Germany.
authors.forename: Kilian Konrad Kenjiro
authors.initials: KKK
authors.lastname: Dahlem
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Centre Freiburg, Killianstrasse 5, 79106, Freiburg, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Pfeiffer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000150:complications* / Q000175:diagnosis* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012468:Salivary Gland Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000401:mortality; D015996:Survival Rate; D055815:Young Adult
keywords: Age; Charlson Comorbidity Index; Outcome; Parotid cancer; Salivary gland cancer; Submandibular gland cancer