Author/Editor		Pukl, Peter; Hočevar-Boltežar, Irena; Šmid, Lojze
Title		Vpliv spremljajočih bolezni in škodljivih razvad na uspeh zdravljenja bolnikov z rakom grla
Translated title		Impact of comorbidity and harmful habits on treatment success in patients with laryngeal cancer
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 76, št. 4
Publication year		2007
Volume		str. 229-35
Language		slo
Abstract		Background Survival of the patients with head and neck cancer is affected by the tumor stage and also by comorbidity. The aim of the study was to evaluate the impact of comorbidity (respiratory, cardiovascular, gastrointestinal, neurological and systemic diseases) and harmful habits on treatment results of laryngeal cancer. Methods Eighty-nine patients with squamous cell carcinoma of the larynx (92% men) who had been surgically treated at the University Department of Otorhinolaryngology and Cervicofacial Surgey in Ljubljana between January 1, 1996 and December 31, 1998 have been included into the retrospective study. Most of the patients were treated with radiotherapy or chemotherapy for the same cancer at the lnstitute of Oncology in Ljubljana. The medical data were obtained from medical hospital records, the data of Slovene Registry of Cancer and the Slovene Institute for Health Care. Results The mean age of the patients was 59.5 years. There were only 4% of non-smokers in the studied population. In 33% of patients excessive consumption of alcohol was documented. In 84% of all patients at least osae comorbidity was detected. Fifty fourpercent of them had pulmonary, 39% cardiovascular, 26% systemic, 25 gastrointestinal, and 3% neurological diseases. Significantly shorter 5 year survival was found in patients with an advanced tumour (p = 0.002 chi2), neck metastases (p = 0.000 chi2), and advanced age (0.042 chi2). The results of the study presented a significant impact of alcohol consumption on survival of our patients (p = 0.014 chi2). The comorbidity was detected more often in patients with excessive alcohol consumption (p = 0.046 chi2) and in olclerpatients (0.018 chi2). The anaesthesiologist š assessment of the patients' health status also influenced their 5 year survival (p = 0.014 (Fisher exact)). (Abstract truncated at 2000 characters)
Summary		Izhodišča. Na preživetje bolnikov z rakom glave in vratu vplivajo poleg razširjenosti tumorja tudi spremljajoče bolezni. Namen raziskave je bil ugotoviti vpliv spremljajočih bolezni (bolezni dihal, obtočil, prebavil, živčevja in sistemskih bolezni) in škodljivih razvad (kajenje, čezmerno uživanje alkohola) na uspešnost zdravljenja raka grla. Metode. V retrospektivno raziskavo je bilo zajetih 89 bolnikov (92% moških) s ploščatoceličnim karcinomom grla, ki so bili kirurško zdravljeni na Kliniki za otorinolaringologijo in cervikofacialno kirurgijo med 1. 1. 1996 in 31. 12. 1998, večina bolnikov pa tudi z obsevanjem in kemoterapijo na Onkološkem inštitutu v Ljubljani. Podatke smo povzeli iz medicinske dokumentacije, podatkov Registra raka Slovenije ter podatkov Inštituta za varovanje zdravja Slovenije.Rezultati. Povprečna starost bolnikov je bila 59,3 leta. Nekadilcev je bilo le 4%. Triintrideset odstotkov bolnikov je čezmerno uživalo alkoholne pijače. Eno ali več spremljajočih bolezni je imelo 84% bolnikov, in sicer 54% pljučne bolezni, 39% srčno-žilne bolezni, 26% sistemske bolezni, 25% bolezni prebavil in 3% nevrološke bolezni. Ugotovili smo, da je manj bolnikov z napredovalimi tumorji (p = 0,002 hi2), bolnikov z ugotovljenimi zasevki v bezgavkah (p = 0,000 hi2) in starejših od 50 let (p = 0,042 hi2) preživelo pet let po koncu zdravljenja. Rezultati so pokazali pomemben vpliv čezmernega uživanja alkoholnih pijač na število bolnikov, ki so preživeli 5 let (p = 0,014 hi2), medtem ko kajenje ni imelo značilnega vpliva. Med bolniki, ki so čezmerno uživali alkohol, so se značilno pogosteje pojavljale tudi spremljajoče bolezni (p = 0,046 hi2), prav tako tudi med bolniki, starejšimi od 50 let (p=0,018 hi2). Prav tako je pet let ali več preživelo več bolnikov z boljšo oceno zdravstvenega stanja, napravljeno pred kirurškim posegom v splošni anesteziji (p = 0,014 [Fisher exact]). (Izvleček prekinjen pri 2000 znakih)
Descriptors		LARYNGEAL NEOPLASMS LARYNGECTOMY CARCINOMA, SQUAMOUS CELL ALCOHOL DRINKING SMOKING SURVIVAL ANALYSIS