Feasibility study of the retrospective use of the Adult Comorbidity Evaluation index (ACE-27) in patients with cancer of the head and neck who had radiotherapy

The Adult Comorbidity Evaluation index (ACE-27) is a relatively new measure of comorbidity and the aim of this study was to assess the feasibility of retrospective examination of casenotes to estimate this index in patients who were given radiotherapy for head and neck cancer. We examined the casenotes of 157 of 168 consecutive patients diagnosed with an index primary tumour of the head and neck at the Clatterbridge Centre of Oncology in 1992 and 1993. Three comorbidity measures, the ACE-27, Charlson comorbidity index (CL) and Washington University Head Neck Cancer Index (WUHNCI) were calculated. In the grading of the ACE-27, 5 patients (3%) were grade 3, 21 (13%) were grade 2, 57 (36%) were grade 1 and 74 (47%) were grade zero. There was a trend in survival by ACE-27 grading with little difference between mild and moderate severity (p = 0.08). There were no significant correlations between survival and either the Charlson index (p = 0.80) or the WUHNCI (p = 0.68). There were no significant correlations of any of the indices or of clinico-demographic factors with recurrence rates.