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

Kouka, Mussab; Büntzel, Jens; Kaftan, Holger; Boeger, Daniel; Mueller, Andréas; Wittig, Andrea; Schultze‐Mosgau, Stefan; Ernst, Thomas; Guntinas‐Lichius, Orlando

doi:10.3390/cancers14133099

Cited by 5 publications

(6 citation statements)

References 25 publications

(41 reference statements)

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“…In the present study, men had a higher risk of early death, in accordance with the findings by Kouka et al in their series of 8288 German HNC patients [ 27 ]. Other studies have not shown a sex-dependent rate of early death in HNC patients [ 12 , 24 ].…”

Section: Discussionsupporting

confidence: 93%

“…Other studies have suggested that estrogen could have a beneficial impact on survival after HNC [ 28 – 31 ], however that correlation was not analyzed here. In consistency with other studies [ 8 , 12 , 24 , 26 , 27 , 32 , 33 ], we saw that higher age and performance status correlated with an increased rate of early death. Furthermore, a hypopharyngeal tumor location, higher stage, and advanced T class were confirmed as significant independent risk factors for six-month mortality, in accordance with previous findings [ 12 , 32 , 34 , 35 ].…”

Section: Discussionsupporting

confidence: 92%

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Six-month mortality has decreased for patients with curative treatment intent for head and neck cancer in Sweden

Talani,

Högmo,

Laurell

et al. 2024

PLoS ONE

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Background In general, survival outcomes for patients with Head and Neck Cancer (HNC) has improved over recent decades. However, mortality within six months after diagnosis for curative patients remains at approximately 5%. The aim of this study was to identify risk factors for early death among patients with curative treatment, and furthermore, to analyze whether the risk of early death changed over recent years. Material and method This real-world, population-based, nationwide study from the Swedish Head and Neck Cancer Register (SweHNCR) included all patients ≥18 years diagnosed with HNC with a curative treatment intent at the multidisciplinary tumor board from 2008 to 2020. A total of 16,786 patients were included. Results During the study period a total of 618 (3.7%) patients with curative-intended treatment died within six months of diagnosis. Patients diagnosed between 2008 and 2012 had a six-month mortality rate of 4.7% compared to 2.5% for patients diagnosed between 2017 and 2020, indicating a risk reduction of 53% (p <0.001) for death within six months. The mean time to radiation therapy from diagnosis in the 2008–2012 cohort was 38 days, compared to 22 days for the 2017–2020 cohort, (p <0.001). The mean time to surgery from diagnosis was 22 days in 2008–2012, compared to 15 days for the 2017–2020 cohort, (p <0.001). Females had a 20% lower risk of dying within six months compared to males (p = 0.013). For every year older the patient was at diagnosis, a 4.8% (p <0.001) higher risk of dying within six months was observed. Patients with a WHO score of 1 had approximately 2.4-times greater risk of early death compared to WHO 0 patients (p <0.001). The risk of early death among WHO 4 patients was almost 28 times higher than for WHO 0 patients (p <0.001). Patients with a hypopharyngeal tumor site had a 2.5-fold higher risk of dying within six months from diagnosis compared to oropharyngeal tumor patients (p <0.001). Conclusions We found that the risk of early death decreased significantly from 2008 to 2020. During this period, the mean time to the start of treatment was significantly reduced both for surgery and oncological treatment regimes. Among patients with a curative treatment intention, increased risk of early death was associated with male sex, older age, advanced disease, increased WHO score, and a hypopharyngeal tumor site.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Six-month mortality has decreased for patients with curative treatment intent for head and neck cancer in Sweden

Talani,

Högmo,

Laurell

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…In the present study, men had a higher risk of early death, in accordance with the findings by Kouka et al in their series of 8288 German HNC patients[21]. Other studies have not shown a sex-dependent rate of early death in HNC patients[12, 18].…”

Section: Discussionsupporting

confidence: 92%

“…Other studies have suggested that estrogen could have a beneficial impact on survival after HNC [22–25], however that correlation was not analyzed here. In consistency with other studies [8, 12, 18, 20, 21, 26, 27], we saw that higher age and performance status correlated with an increased rate of early death. Furthermore, a hypopharyngeal tumor location, higher stage, and advanced T class were confirmed as significant independent risk factors for six-month mortality, in accordance with previous findings[12, 26, 28, 29].…”

Section: Discussionsupporting

confidence: 92%

Six-month mortality has decreased for patients with curative treatment for head and neck cancer in Sweden

Talani,

Högmo,

Laurell

et al. 2023

Preprint

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BackgroundIn general, survival outcome for head and neck cancer (HNC) patients has improved. However, mortality within six months after diagnosis with curative intent remains high. The aim of this study was to identify risk factors for early death among patients with curative treatment, and furthermore, to analyze whether the risk of early death changed over the recent years.Material and MethodThis real-world, population-based, nationwide study from the Swedish Head and Neck Cancer Register (SweHNCR) included 16,786 patients with curative treatment decision at the multidisciplinary tumor board from 2008 to 2020.ResultsDuring the study period a total of 618 (3.7%) patients with curative-intended treatment died within six months from diagnosis. Patients diagnosed between 2008–2012 had a six-month mortality rate of 4.7% compared to 2.5% for patients diagnosed 2017–2020, indicating a risk reduction of 53% (p <0.001) for death within six months. The mean time to radiation therapy in the 2008–2012 cohort was 38 days, compared to 22 days for the 2017– 2020 cohort, (p<0.001). The mean time to surgery from diagnosis was 22 days in 2008–2012, compared to 15 days for the 2017–2020 cohort, (p <0.001).Females had a 20% lower risk of dying within six months compared to males (p =0.013). For every year older the patient was at diagnosis, a 4.8% (p <0.001) higher risk of dying within six months was observed. Patients with a WHO score of 1 had approximately 2.4-times greater risk of early death compared to WHO 0 patients (p <0.001). The risk of early death among WHO 4 patients was almost 28 times higher than for WHO 0 patients (p <0.001)ConclusionsWe found that the risk of early death decreased significantly from 2008 to 2020. During this period the mean time to the start of treatment, was significantly reduced both for surgery and oncological treatment regimes. Among patients with a curative treatment intention, increased risk of early death was associated with male sex, older age, advanced disease, increased WHO score, and a hypopharyngeal tumor site.Brief description*The risk of early death decreased significantly from 2008 to 2020.*Time from diagnosis to treatment decreased between 2008 to 2020.*Among patients with a curative treatment intention, increased risk of early death was associated with male sex, older age, advanced disease, increased WHO score, and a hypopharyngeal tumor site.Ethical ConsiderationsThe Regional Ethical Review Board in Gothenburg and Lund reviewed and approved the study, (Gothenburg, number 299–14, T230-17 and Lund 2020-01972). This study was carried out in accordance with the current Helsinki Declaration of the World Medical Association from 2013. Data are available upon request.

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“…The National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) registry, the National Cancer Database (NCDB), or national cancer registries record patient and tumor characteristics as well as survival data, but typically not data on functional outcome 11 – 13 . To overcome this limitation, all eight Department of Otorhinolaryngology, Head and Neck Surgery in Thuringia, a federal state in Germany, have established the Thuringian Head And Neck Cancer Study (THANCS) Group allowing population-based analysis of all head and neck cancer patients treated in one German federal state with about two million inhabitants 14 , 15 . Furthermore, the network established a linkage between data from all five Thuringian cancer registries and the data of the patients’ charts in the eight hospitals, i.e.…”

Section: Introductionmentioning

confidence: 99%

Oncological and functional outcome after laryngectomy for laryngeal and hypopharyngeal cancer: a population-based analysis in Germany from 2001 to 2020

Kouka,

Beckmann,

Bitter

et al. 2024

Sci Rep

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Prognostic factors for overall survival (OS), percutaneous endoscopic gastrostomy (PEG) dependency, and long-term speech rehabilitation via voice prosthesis (VP) after laryngectomy for laryngeal or hypopharyngeal cancer were investigated in a retrospective population-based study in Thuringia, Germany. A total of 617 patients (68.7% larynx; hypopharynx; 31.3%; 93.7% men; median age 62 years; 66.0% stage IV) from 2001 to 2020 were included. Kaplan–Meier and Cox multivariable regression analyses were performed. 23.7% of patients received a PEG. 74.7% received a VP. Median OS was 131 months. Independent factors for lower OS were stage IV (compared to stage II; hazard ratio [HR] = 3.455; confidence interval [CI] 1.395–8.556) and laryngectomy for a recurrent disease (HR = 1.550; CI 1.078–2.228). Median time to PEG removal was 7 months. Prior partial surgery before laryngectomy showed a tendency for independent association for later PEG removal (HR = 1.959; CI 0.921–4.167). Postoperative aspiration needing treatment was an independent risk factor (HR = 2.679; CI 1.001–7.167) for later definitive VP removal. Laryngectomy continuously plays an important role in a curative daily routine treatment setting of advanced laryngeal or hypopharyngeal cancer in Germany. Long-term dependency on nutrition via PEG is an important issue, whereas use of VP is a stable long-term measure for voice rehabilitation.

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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

Cited by 5 publications

References 25 publications

Six-month mortality has decreased for patients with curative treatment intent for head and neck cancer in Sweden

Six-month mortality has decreased for patients with curative treatment intent for head and neck cancer in Sweden

Six-month mortality has decreased for patients with curative treatment for head and neck cancer in Sweden

Oncological and functional outcome after laryngectomy for laryngeal and hypopharyngeal cancer: a population-based analysis in Germany from 2001 to 2020

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