Functional and cognitive impairment , depressive symptoms and social isolation are highly prevalent in head and neck cancer patients and associate with high risk of adverse health outcomes .
OBJECTIVES Older head and neck cancer patients are at increased risk for adverse health outcomes , but little is known about which geriatric assessment associates with poor outcome .
The aim is to study the association of functional or cognitive impairment , social environment and frailty with adverse health outcomes in patients with head and neck cancer .
Comorbidity and Karnofksy performance score are independent prognostic factors in stage III non-small-cell lung cancer: an institutional analysis of patients treated on four RTOG studies. Radiation Therapy Oncology Group.
PURPOSE To determine the prognostic role of comorbidity in Stage III non-small cell lung cancer ( NSCLC ) treated definitively with radiotherapy alone . METHODS AND MATERIAL S A total of 112 patients with clinical Stage III NSCLC ( American Joint Commission on Cancer 1997 ) enrolled in four Radiation Therapy Oncology Group studies ( 83 - 11 , 84 - 03 , 84 - 07 , and 88 - 08 nonchemotherapy arms ) at a single institution were analyzed retrospectively for overall survival ( OS ) and comorbidity . Of the 112 patients , 105 ( 94 % ) completed their assigned radiotherapy . The median assigned dose was 50.4 Gy to the lymphatics ( range 45 - 50.4 Gy ) and 70.2 Gy to the primary tumor ( range 60 - 79.2 Gy ) . Comorbidity was rated retrospectively using the Cumulative Illness Rating Scale for Geriatrics ( CIRS-G ) and Charlson scales . Karnofsky performance scores ( KPSs ) and weight loss were prospect ively recorded . Because only 8 patients had a KPS of < 70 , these patients were combined with patients who had a KPS of 70 . The OS of this group was compared with that of the patients with better KPSs ( > 70 ) . RESULTS The median survival was 10.39 months ( range 7.87 - 12.91 ) . The 2- , 3- , and 5-year OS rate was 20.5 % , 12.5 % , and 7.1 % , respectively . On univariate analysis , clinical stage ( IIIA vs. IIIB ) was found to be a statistically significant factor influencing OS ( p = 0.026 ) , and the histologic features , grade , tumor size as measured on CT scans , age , tobacco use , weight loss > or=5 % , and total dose delivered to the primary tumor were not . A KPS of < or=70 ( p = 0.001 ) , the presence of a CIRS-G score of 4 ( extremely severe ; p = 0.0002 ) , and a severity index of > 2 ( p < 0.0001 ) were associated with statistically significant inferior OS . Multivariate analysis with clinical stage , KPS , and comorbidity ( severity index ) of all patients showed that a KPS < or=70 and severity index > 2 were independently associated with inferior OS ; clinical tumor stage was not found to be an independent prognostic factor . CONCLUSION KPS and comorbidity are important independent prognostic factors in Stage III NSCLC . Comorbidity should be included in protocol s study ing advanced stage NSCLC and used for stratification
Functional and cognitive impairment , depressive symptoms and social isolation are highly prevalent in head and neck cancer patients and associate with high risk of adverse health outcomes .
OBJECTIVES Older head and neck cancer patients are at increased risk for adverse health outcomes , but little is known about which geriatric assessment associates with poor outcome .
The aim is to study the association of functional or cognitive impairment , social environment and frailty with adverse health outcomes in patients with head and neck cancer .