Patients with head and neck cancer: Are they frailer than patients with other solid malignancies?

Eur J Cancer Care (Engl). 2020 Jan;29(1):e13170. doi: 10.1111/ecc.13170. Epub 2019 Sep 30.

Abstract

Objective: We aimed to compare frailty status between patients with head and neck cancer (HNC) and other solid malignancies.

Methods: Data collection was prospective, and the following were compared between cohorts at baseline: patient and tumour characteristics, Charlson Comorbidity Index (CCI), Groningen Frailty Indicator (GFI), Mini Mental State Examination (MMSE), Activities of Daily Living (ADLs), Instrumental ADLs (IADLs), Timed Up and Go (TUG) and Quality of Life (QoL). Univariate and multivariate logistic regression analyses were performed, and odds ratios (ORs) with their 95% confidence intervals (95% CIs) were estimated.

Results: In total, 242 patients with HNC and 180 with other oncology diagnoses were enrolled, of whom 32.6% and 21.8% were frail according to the GFI respectively. Comorbidity scores were not significantly different between the cohorts (7.4% vs. 13.1%; OR 0.54; 95% CI 0.28-1.02). In the univariate analysis, the GFI was significantly worse in the HNC cohort (OR 1.74; 95% CI 1.11-2.71). However, in the multivariate analysis, the MMSE, TUG and global QoL were significantly worse in the HNC cohort, with ORs of 20.03 (95% CI 2.44-164.31), 11.56 (95% CI 1.86-71.68) and 0.98 (95% CI 0.97-1.00) respectively.

Conclusion: Patients with HNC appear to be frailer than patients with other solid malignancies despite comparable levels of comorbidity.

Keywords: frail elderly; frailty; geriatric assessment; geriatric oncology; head and neck cancer; quality of life.

Publication types

  • Observational Study

MeSH terms

  • Activities of Daily Living
  • Aged
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / pathology
  • Breast Neoplasms / physiopathology
  • Case-Control Studies
  • Digestive System Neoplasms / epidemiology
  • Digestive System Neoplasms / pathology
  • Digestive System Neoplasms / physiopathology
  • Female
  • Frailty / epidemiology*
  • Frailty / physiopathology
  • Genital Neoplasms, Female / epidemiology
  • Genital Neoplasms, Female / pathology
  • Genital Neoplasms, Female / physiopathology
  • Geriatric Assessment
  • Head and Neck Neoplasms / epidemiology*
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / physiopathology
  • Humans
  • Kidney Neoplasms / epidemiology
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / physiopathology
  • Logistic Models
  • Male
  • Mental Status and Dementia Tests
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Netherlands / epidemiology
  • Odds Ratio
  • Physical Functional Performance
  • Quality of Life
  • Skin Neoplasms / epidemiology
  • Skin Neoplasms / pathology
  • Skin Neoplasms / physiopathology
  • Soft Tissue Neoplasms / epidemiology
  • Soft Tissue Neoplasms / pathology
  • Soft Tissue Neoplasms / physiopathology
  • Squamous Cell Carcinoma of Head and Neck / epidemiology*
  • Squamous Cell Carcinoma of Head and Neck / pathology
  • Squamous Cell Carcinoma of Head and Neck / physiopathology
  • Thyroid Neoplasms / epidemiology
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / physiopathology