Department of Otolaryngology, Asan Medical Center, University of Ulsan, College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul 138-736, Republic of Korea.
Ann Oncol. 2013 Apr;24(4):1049-54. doi: 10.1093/annonc/mds540. Epub 2012 Nov 8.
Cancer progression and non-cancer-related morbidities can affect the quality of life and survival of patients with head and neck squamous cell carcinomas (HNSCC). The aim of this study was to investigate the risk factors for the development of non-cancer health events (NCHEs) in HNSCC.
The study involved 465 previously-untreated patients with HNSCC diagnosed between 2005 and 2009 at the Asan Medical Center. Non-cancer-associated morbidity was defined as readmission after treatment of HNSCC due to non-cancer-related causes. NCHEs were defined as the occurrence of non-cancer-associated morbidity or mortality. The incidence and risk factors for NCHEs were analyzed.
During the median follow-up of 47.6 months, non-cancer morbidity and mortality occurred in 83 (17.8%) and 25 patients (5.4%), respectively. Thirteen patients (52%) died from non-cancer-related causes with no previous admission for non-cancer causes. Multivariate analysis showed that the incidence of NCHEs was significantly associated with a Charlson comorbidity index ≥1 and stage III/IV disease (P < 0.001).
Patients with comorbidities and advanced diseases may be at higher risk of NCHEs. Because NCHEs are sometimes life-threatening, every effort should be made to avoid unexpected non-cancer-associated mortality in the HNSCC patients.
癌症进展和非癌症相关的疾病会影响头颈部鳞状细胞癌(HNSCC)患者的生活质量和生存。本研究旨在探讨 HNSCC 患者非癌症健康事件(NCHE)发生的危险因素。
本研究纳入了 2005 年至 2009 年期间在 Asan 医疗中心诊断为 HNSCC 的 465 例未经治疗的患者。非癌症相关发病率定义为 HNSCC 治疗后因非癌症相关原因再次入院。NCHE 定义为非癌症相关发病率或死亡率的发生。分析了 NCHE 的发生率和危险因素。
在中位随访 47.6 个月期间,83 例(17.8%)和 25 例(5.4%)患者分别发生了非癌症发病率和死亡率。13 例(52%)患者因非癌症相关原因死亡,且此前无非癌症相关入院记录。多变量分析表明,NCHE 的发生率与 Charlson 合并症指数≥1 和 III/IV 期疾病显著相关(P < 0.001)。
合并症和晚期疾病的患者发生 NCHE 的风险可能更高。由于 NCHE 有时会危及生命,因此应尽一切努力避免 HNSCC 患者发生意外的非癌症相关死亡。