Early death among head and neck cancer patients

Farnebo, Lovisa; Malila, Nea; Mäkitie, Antti; Laurell, Göran

doi:10.1097/moo.0000000000000236

Cited by 13 publications

(11 citation statements)

References 42 publications

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“…Two previous Swedish studies based on data from 6785 and 9733 HNC patients reported 180-day mortality of 9.8% and 9.5%, respectively [7,8]. These results are consistent with our 180-day mortality of 9.6%.…”

Section: Discussionsupporting

confidence: 93%

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Early Mortality among Patients with Head and Neck Cancer Diagnosed in Thuringia, Germany, between 1996 and 2016—A Population-Based Study

Kouka

Büntzel

Kaftan

et al. 2022

Cancers

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Population-based studies on early mortality in head and neck cancer (HNC) are sparse. This retrospective population-based study investigated early mortality of HNC and the influence of patients’ tumor and treatment characteristics. All 8288 patients with primary HNC of the German federal state Thuringia from 1996 to 2016 were included. Univariate and multivariate analysis were performed to identify independent factors for 30-day, 90-day, and 180-day mortality. The 30-, 90-, and 180-day mortality risks were 1.8%, 5.1%, and 9.6%, respectively. In multivariable analysis, male sex (odds ratio (OR) 1.41; 95% confidence interval (CI) 1.08–1.84), increasing age (OR 1.81; CI 1.49–2.19), higher T (T4: OR 3.09; CI 1.96–4.88) and M1 classification (OR 1.97; CI 1.43–2.73), advanced stage (IV: OR 3.97; CI 1.97–8.00), tumors of the cavity of mouth (OR 3.47; CI 1.23–9.75), oropharynx (OR 3.01; CI 1.06–8.51), and hypopharynx (OR 3.27; CI 1.14–9.40) had a significantly greater 180-day mortality. Surgery (OR 0.51; CI 0.36–0.73), radiotherapy (OR 0.37; CI 0.25–0.53), and multimodal therapy (OR 0.10; CI 0.07–0.13) were associated with decreased 180-day mortality. Typical factors associated with worse overall survival had the most important impact on early mortality in a population-based setting.

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Section: Discussionsupporting

confidence: 93%

“…In nationwide studies of the Swedish and Finnish databases, early mortality at 180 days was about 9-10% [8]. The causes of early mortality may be either tumor-related, patientrelated, treatment-related, or due to perioperative mortality.…”

Section: Introductionmentioning

confidence: 99%

Early Mortality among Patients with Head and Neck Cancer Diagnosed in Thuringia, Germany, between 1996 and 2016—A Population-Based Study

Kouka

Büntzel

Kaftan

et al. 2022

Cancers

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“…Studies on the incidence and aetiology of early death among patients with cancers of the head and neck are still scarce, and to our knowledge this is not only the first official report to describe the SweHNCR data on 9733 such patients, but also the first attempt in Europe to investigate early death among patients in a nationwide population-based series. A previous Swedish study based on the data from 6785 such patients during the period 2008–2013 indicated a risk of death within six months of 665 (9.8%) [9]. In the present study we found a slightly reduced risk of early death of 925/9733 patients during the extended period 2008–2015 (9.5%).…”

Section: Discussionsupporting

confidence: 59%

“…Both surgical and oncological treatments usually have acute side effects, but may also result in long-term consequences, and even death. Apart from our own recent review [9], the issue of early death (within six months of diagnosis) among patients with cancer of the head and neck remains poorly explored. Patients with improved survival are often HPV positive, of working age, and have only a few coexisting conditions, and for these patients reductions in treatment have been discussed [10, 11].…”

Section: Introductionmentioning

confidence: 99%

Early mortality after diagnosis of cancer of the head and neck – A population-based nationwide study

Talani¹,

Mäkitie²,

Beran³

et al. 2019

PLoS ONE

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BackgroundCancers of the head and neck have a high mortality rate, and roughly 10% of the patients die within six months of diagnosis. To our knowledge little has been written about this group.We wished to identify risk factors for early death, to predict and monitor patients at risk better and, if possible, avoid unjustified major treatment.Methods and findingsThis population-based nationwide study from the Swedish Head and Neck Cancer Register (SweHNCR) included data from 2008–2015 and 9733 patients at potential risk of early death.A total of 925 (9.5%) patients died within six months. For every year older the patients became, the risk of early death increased by 2.3% (p<0.001). The relative risk of death was 3.37 times higher (237%) for patients with WHO score 1 compared with WHO score 0. A primary tumour in the hypopharynx correlated with a 24% increased risk over the oral cavity (p<0.024). Patients with stage IV disease had a 3.7 times greater risk of early death than those with stage I (p<0.001). As expected, a 12 times increased risk of early death was noted in the palliative treatment group, compared to the curative group.Limitations to this study were that the actual cause of death was not recorded in the SweHNCR, and that socioeconomic factors, alcohol consumption, smoking habits, and HPV status, were not reported in SweHNCR until 2015. However, the fact that this is a population-based nationwide study including 9733 patients compensates for some of these limitations.ConclusionsIdentification of patients at increased risk of early death shows that older patients with advanced disease, increased WHO score, primary tumour in the hypopharynx, and those given palliative treatment, are more likely than the others to die from head and neck cancer within six months of diagnosis.

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“…(6,7) A significant proportion of patients with head and neck cancer die due to the outcomes of malnutrition rather than malignancy itself. (8) Different screening tools have, over the time, been validated such as Nutritional Risk Screening Tool 2002 (NRS 2002), Malnutrition Universal Screening Tool, Nutritional Risk Index, etc. Over the time these tools have aided the health professionals to identify the risk of malnutrition in cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Screening for malnutrition in oral cavity cancer patients prior to treatment: a cross-sectional study

et al. 2020

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Abstract This study was conducted to assess the frequency of pre-operative malnourishment in patients being treated for oral cavity squamous cell carcinoma. A retrospective chart review was carried out at the Aga Khan University Hospital, Karachi, on 62 patients. Patients were screened pre-operatively through a standard nutritional assessment tool at the time of admission to assess for malnutrition. Mean age of presentation was 48.34 ± 13.11 years, mean height was 165 ± 8.62cm, weight 66.09 ± 14.98 kg and BMI of 24.09 ± 4.84. Males were 82.3% and 17.7% were females. At the time of admission, a significant number or patients, 12 (19.4%) were prone to malnourishment, while 3 (4.8%) patients were malnourished: Assessment was done by using a standardised nutritional assessment tool. Keywords: Malnutrition, Squamous cell Carcinoma, Radiotherapy Continuous...

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Early death among head and neck cancer patients

Abstract: The present review provides information on the mechanisms leading to early phase mortality (<6 months) after management of HNC. It also reports the incidence of this phenomenon among Finnish and Swedish patient populations.

Cited by 13 publications

References 42 publications

Early Mortality among Patients with Head and Neck Cancer Diagnosed in Thuringia, Germany, between 1996 and 2016—A Population-Based Study

Early Mortality among Patients with Head and Neck Cancer Diagnosed in Thuringia, Germany, between 1996 and 2016—A Population-Based Study

Early mortality after diagnosis of cancer of the head and neck – A population-based nationwide study

Screening for malnutrition in oral cavity cancer patients prior to treatment: a cross-sectional study

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