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Risk factors for competing non‐cancer mortality after definitive treatment for advanced‐stage head and neck cancer
Author(s) -
Kim Yong Han,
Roh JongLyel,
Kim SungBae,
Choi SeungHo,
Nam Soon Yuhl,
Kim Sang Yoon
Publication year - 2018
Publication title -
oral diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.953
H-Index - 87
eISSN - 1601-0825
pISSN - 1354-523X
DOI - 10.1111/odi.12904
Subject(s) - medicine , cancer , head and neck cancer , comorbidity , prospective cohort study , stage (stratigraphy) , proportional hazards model , oncology , hazard ratio , incidence (geometry) , multivariate analysis , cumulative incidence , cohort , confidence interval , paleontology , physics , optics , biology
Objective Patients with head and neck cancer ( HNC ) can die of index tumor progression and second tumor or non‐cancer causes. Here, we investigated the risk factors for competing non‐cancer mortality ( NCM ) in a prospective cohort of patients with advanced‐stage HNC . Materials and Methods A prospective observational study was conducted with 604 patients who underwent definitive treatment for advanced‐stage HNC between 2010 and 2015. Main outcomes were NCM and cancer mortality ( CM ) defined as death from non‐cancer causes and HNC or second cancers, respectively. Cumulative incidence and cause‐specific hazard functions were used to analyze the risk factors of NCM and CM . Results Age, smoking, Charlson comorbidity index ( CCI ), performance status, body mass index, rural residence, education and hemoglobin level at diagnosis, and chemotherapy were significantly associated with NCM (all p < 0.05). Multivariate analyses showed that age, CCI , and hemoglobin were independent factors of NCM . Age (≥65 years), CCI (≥2), and hemoglobin (<11 g/dl) were related to 4.5‐, 3.2‐, and 2.7‐fold increased adjusted risk of NCM , respectively. Conclusions Old age, comorbidity, and hemoglobin at diagnosis were independent predictors of NCM . The risk factors could be used to predict non‐cancer death after definitive treatment for advanced‐stage HNC .