Background: Researches on noncancer causes of death in patients with esophageal cancer (EC) are not in-depth. The objective of this paper is to broadly and deeply explore the causes of death in patients with EC, especially noncancer causes. Methods: Information about the demographics, tumor-related characteristics, and causes of death of patients with EC who met the inclusion criteria were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Calculated standardized mortality ratio (SMR) for all causes of death at different follow-up times and performed subgroup analyses. Results: In total, 63,560 patients with EC were retrieved from the public database. And 52,503 died during the follow-up period. Most deaths were due to EC itself within 5 years after diagnosis, but over 10 years, 59% EC patients died from noncancer causes. Cardiovascular disease was the major noncancer cause of death in patients with EC, accounting for 43%. Suicide and self-injury (2%) of EC patients should not be ignored. During the 1-year follow-up period, patients with EC had statistically highest risk of death from septicemia (SMR: 7.61; 95% CI: 6.38-9.00). Within more than 10 years after EC diagnosis, more and more patients died from chronic obstructive pulmonary disease (SMR: 2.38; 95% CI: 1.79-3.10). Conclusions: Although most patients with EC still died from the cancer itself, the role of noncancer causes of death should not be underestimated. These prompt clinicians to pay more attention to the risk of death caused by these noncancer causes, which can provide relevant measures in advance to intervene.
This research aimed to investigate the prognostic factors of oral squamous cell carcinoma (OSCC), especially the role of age. A total of 33619 cases of OSCC were received from the Surveillance, Epidemiology, and End Results database during 2005–2015. Kaplan-Meier curves of 5-year overall survival rates and 5-year cancer specific survival rates were performed, and univariate and multivariate Cox regression analysis as well as competing risk model were used to help understand the relationship between various factors and mortality of OSCC. Compared to 18–39 years old group, the older age was an important predictor of worse prognosis. The multivariate analysis of overall survival (OS) were 50–59 years old (HR, 1.32; 95% CI, 1.17–1.48; p ≤ .001), 60–69 years old (HR, 1.66; 95% CI, 1.42–1.87; p ≤ .001) and 70 + years old (HR, 3.21; 95% CI, 2.86–3.62; p ≤ .001) respectively, while the specific value of competing risk model were 60–69 years old (HR, 1.21; 95% CI, 1.07–1.38; p = .002) and 70 + years old (HR, 1.85; 95% CI, 1.63–2.10; p ≤ .001). In addition, female gender, unmarried, Blacks, tumor in floor of mouth, size and higher TNM classification were also other predictors that signify significant clinically deterioration of OS / CSS. Our research revealed that age was an important factor in explaining the difference of survival in the whole process of OSCC. It’s suggested that we should pay attention to the influence of age on diagnosis, treatment and prognosis in the clinical process.
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