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


Autoři: Charbél Talani aff001;  Antti Mäkitie aff003;  Martin Beran aff006;  Erik Holmberg aff007;  Göran Laurell aff008;  Lovisa Farnebo aff001
Působiště autorů: Division of Speech language pathology, Audiology and Otorhinolaryngology, Department of Clinical and Experimental medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden aff001;  Department of Otorhinolaryngology in Linköping, Anaesthetics, Operations and Specialty Surgery Center, Region Östergötland, Linköping, Sweden aff002;  Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland aff003;  Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden aff004;  Research Programme in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland aff005;  Department of ENT and Maxillofacial Surgery, NAL Medical Center Hospital, Trollhattan, Sweden aff006;  Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden aff007;  Department of Clinical Sciences, ENT, Uppsala University, Uppsala, Sweden aff008
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223154

Souhrn

Background

Cancers 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 findings

This 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.

Conclusions

Identification 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.

Klíčová slova:

Cancer detection and diagnosis – Cancer treatment – Head – Head and neck cancers – Neck – Surgical and invasive medical procedures – Sweden – Salivary glands


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PLOS One


2019 Číslo 10

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