Age-Adjusted Charlson Comorbidities Index for Survival Prognosis in Laryngeal Squamous Cell Carcinoma Patients

This study aimed to explore the prognostic relevance of the age-adjusted Charlson Comorbidity Index (ACCI) in laryngeal squamous cell carcinoma (LSCC) survival.

This retrospective analysis was conducted on the medical records of 367 LSCC patients admitted to the First Hospital of Shanxi Medical University, China, from January 2012 to December 2015. The cohort (n = 367) comprised 351 males and 16 females aged 40-88 years. ACCI scores were categorized into three groups: high (7-12), moderate (5-6), and low (2-4). Prognostic factors were analyzed using the multivariable Cox proportional hazards regression model, and dynamic prognostic nomograms and calibration curves were generated based on the results. Model performance was evaluated using the C-index.

In this cohort of 367 LSCC patients, the 5-year overall survival (OS) rate was 58.6%. Meanwhile, the 5-year progression-free survival (PFS) rate was 64.3%, and the cancer-specific survival (CSS) rate was 61.9%. Cox regression analysis identified ACCI, T stage, distant metastasis, and degree of differentiation as independent risk factors for both OS and CSS (p < 0.05). Additionally, a dynamic prognostic nomogram was established and validated, with a C-index of 0.75 (95% CI: 0.711-0.788) and 0.753 (95% CI: 0.714-0.792) for OS and CSS, respectively. High ACCI emerged as a pivotal survival prognosticator for LSCC patients. Thus, a more convenient and precise dynamic predictive model for formulating treatment strategies can be formulated by incorporating ACCI, T stage, metastasis, and differentiation.

Overall, this study advances our understanding of ACCI's prognostic significance and its role in guiding LSCC management to improve clinical outcomes.