The Importance of Comorbidity Assessment in Patients with Oral Squamous Cell Carcinoma (OSCC): Could the Adult Comorbidity Evaluation-27 (ACE-27) Provide an Additional Information?

Background: Disease stage is the most powerful prognostic factor in OSCC but is not accurate enough to identify highest risk patients. Other patient-related conditions as comorbidity add relevant prognostic value. We show the importance of the comorbidity assessment in contrast to other historic prognosis factors. Methods: Retrospective review of patients with resectable OSCC from 2011 to 2014. Baseline pretreatment comorbidity data were collected according to ACE–27. Clinical, pathological, presurgical blood samples and treatment data were collected. Kaplan-Meier and Cox proportional hazards modeling were used to determine associations with OS (Overall Survival), DSS (Disease-Specific Survival) and DFS (Disease-Free Survival). Results: Among 215 patients, median age was 67 years (range 32-96). Median follow-up was 31 months (1– 78). 74% suffered at least one previous comorbid condition. 3-year OS, DSS and DFS were 68%, 77% and 65%, respectively. The multivariable model is showed in the table. Suffering a severe comorbidity had the highest prognostic value, greater than present a locally advanced OSCC [HR = 6.24; 95%CI=2.08-18.67p< 0.001].Table: 1107PMultivariable modelVariableHR95%CIpLow comorbidity2.61[0.95-7.21]0.006Moderate comorbidity3.17[1.24-8.11]0.02Severe comorbidity6.24[2.08-18.67]<0.001Haemoglobin < 13.6 g/dL1.92[1.04-3.55]0.04Stage II2.57[0.87-7.58]0.009Stage III-IV4.10[1.15-14.67]0.03N0. Watchful waiting2.82[0.98 – 8.12]0.05Therapeutic neck disection2.57[1- 6.60]0.05PLR (platelets to lymphocytes ratio ) >663.98[0.88-17.93]0.07Age > 802.88[1.28-6.46]0.01 Open table in a new tab Conclusions: We described the account of comorbidity assessment as a prognosis factor of resectable OSCC. We provide the importance of additional clinical and easily accessible information to tumor stage, capable of discriminating prognostic risk factors in resectable OSCC. Legal entity responsible for the study: The Clinical Research Ethics Committee of Aragón (CEIC-A). Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.