Abstract 666: The effect of comorbidity, smoking and alcohol on survival of head and neck cancer anatomic subsites: A retrospective analysis of 4689 patients
Notice bibliographique
Résumé
Abstract Background: Increased age and greater comorbidity are independent predictors of worse survival in nasopharyngeal and squamous cell cancers of the head and neck (HNC). The Charlson Comorbidity Index (CCI) provides a quantitative measure of comorbidity that can be abstracted from medical charts. We evaluated the role of anatomic subsite, smoking, alcohol, demographic and other variables on the impact of overall survival (OS) in HNC. Methods: Retrospective chart review was performed for 4689 HNC patients identified by the Princess Margaret Hospital and Ontario Cancer Registries (Toronto, Canada), between 2000 and 2010. Demographic (age, gender, occupation, marital status), and histologic variables were abstracted in addition to smoking and drinking consumption (current, former, never) and quantity (cigarettes: pack-years; alcohol usage: non/light, moderate, and heavy). CCI were categorized as no comorbidities (CCI 0), mild (CCI 1-2), moderate (CCI 3-4), and severe comorbidity (CCI 5+), respectively. HPV status in oropharyngeal tumors was assessed using p16 immunohistochemistry. Results: The population was mostly male (73%), married/common-law (71%), and median 63 years of age. Disease site consisted of 35% oral cavity, 28% oropharynx, 29% larynx, 6% hypopharynx, and 3% nasopharynx. Most tumors were stage III/IV (67%) and moderately differentiated (65%). Patients were categorized with 7% severe, 17% moderate, 47% mild, and 30% with no comorbidity. 79% of patients were ever-smokers and 84% were ever-drinkers. 481/688 OPC tumors were HPV+. Overall survival (OS) was better in younger patients (HR 1.03 per year, p < 0.0001), and those in married/common-law relationships (HR 1.48, p < 0.001). Greater comorbidity was associated with poorer OS: HR 1.5 (p < 0.0001), 2.0 (p < 0.0001), and 2.4 (p < 0.0001) for mild, moderate, and severe comorbidity, respectively. Univariately, oropharyngeal cancer had superior OS than cancers of the hypopharynx (HR 2.3, p < 0.0001) and oral cavity (HR 1.2, p = 0.006) but not the larynx (HR 0.97, p = 0.59) and worse OS than cancers of the nasopharynx (HR 0.54, p = 0.001). Advanced overall TNM stage was associated with poorer OS (HR 2.42, p < 0.0001), but grade was not significantly associated with survival. In terms of treatment, surgery alone (HR 0.63, p < 0.0001), surgery with post-operative radiation (HR 0.82, p = 0.004), and surgery followed by chemoradiotherapy (HR 0.76, p = 0.02) resulted in better OS than radiation alone. Heavier smoking and alcohol consumption resulted in poorer OS. For oropharyngeal cancer patients alone, HPV positivity improved OS (HR 0.30, p < 0.0001). Conclusion: In addition to stage, other important factors including social, demographic, treatment, histologic, and comorbidity variables also impact survival, and should be considered as prognostic factors in analyses of HNC. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 666. doi:1538-7445.AM2012-666
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».