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

Objective:This study aimed to explore the prognostic relevance of the age-adjusted Charlson Comorbidity Index(ACCI)in laryngeal squamous cell carcinoma(LSCC)survival.Methods: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 theC-index.Results: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 aC-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.Conclusions:Overall,this study advances our understanding of ACCI''''s prognostic significance and its role in guiding LSCC management to improve clinical outcomes.