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Multidimensional Prognostic Index as a Predictor of Mortality in Head and Neck Cancer Patients: A Cohort Study
Ajay T Bakas1, Aniel Sewnaik1, Femke Flikweert2
1Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC University Cancer Institute, Rotterdam, the Netherlands.
Background:
Head and neck cancer (HNC) significantly impacts older adults, with mortality influenced by multiple factors. The Multidimensional Prognostic Index (MPI), derived from comprehensive geriatric assessment (CGA), may improve risk stratification and clinical decision making.
Methods:
An observational cohort study was conducted at Erasmus Medical Center, Rotterdam, from December 2019 to June 2021. We included 423 HNC patients aged 70 years or older or younger patients with a G8 score of 14 or less. MPI stages were determined through CGA, categorized into stages 1, 2, and 3.
Results:
During a median follow-up of 595 days, 115 patients (29%) died. MPI stage 2 and stage 3 were associated with a higher mortality risk compared to MPI stage 1 (HR 2.18; 95% CI 1.46-3.26). In the surgical subgroup, similar mortality risks were observed, but MPI stages did not correlate with postoperative complications.
Conclusions:
MPI stages derived from CGA effectively predict mortality risk in older HNC patients, though they do not predict postoperative complications.
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