Functional and cognitive impairment , depressive symptoms and social isolation are highly prevalent in head and neck cancer patients and associate with high risk of adverse health outcomes .
OBJECTIVES Older head and neck cancer patients are at increased risk for adverse health outcomes , but little is known about which geriatric assessment associates with poor outcome .
The aim is to study the association of functional or cognitive impairment , social environment and frailty with adverse health outcomes in patients with head and neck cancer .
Predictors of competing mortality in advanced head and neck cancer.
PURPOSE Death from noncancer causes ( competing mortality ) is an important event in head and neck cancer , but studies identifying predictors of this event are lacking . We sought to identify predictors of competing mortality and develop a risk stratification model for competing events . PATIENTS AND METHODS Cohort study of 479 patients with stage III to IV carcinoma of the head and neck diagnosed between August 1993 and November 2004 . Patients were treated on consecutive prospect i ve clinical trials involving organ-preserving chemoradiotherapy and surgery . We used multivariable competing risks regression models to analyze factors associated with the cumulative incidence of competing mortality , locoregional and distant failure , and second malignancies as first events . Results Median follow-up was 52 months median for survivors . The 5-year cumulative incidence of competing mortality was 19.6 % ( 95 % CI , 15.8 to 23.4 ) . On multivariable analysis , competing mortality was associated with female sex ( hazard ratio [ HR ] , 1.72 ; 95 % CI , 1.13 to 2.63 ) , increasing age ( HR , 1.30 ; 95 % CI , 1.04 to 1.62 ) , increasing Charlson Comorbidity Index ( HR , 1.24 ; 95 % CI , 1.05 to 1.47 ) , decreasing body mass index ( HR , 0.33 ; 95 % CI , 0.13 to 0.84 ) , and decreasing distance traveled to the treating center ( HR , 0.65 ; 95 % CI , 0.44 to 0.98 ) . Patients with zero , one , two , and > or = three risk factors had 5-year competing mortality of 8.9 % ( 95 % CI , 3.0 % to 14.8 % ) , 12.4 % ( 95 % CI , 7.0 % to 17.8 % ) , 22.1 % ( 95 % CI , 14.5 % to 29.7 % ) , and 39.3 % ( 95 % CI , 28.6 % to 50.1 % ) , respectively . CONCLUSION Competing mortality in advanced head and neck cancer is associated with several demographic and health status characteristics . Analyses of risk factors for competing mortality may be useful in outcomes reporting and design ing clinical trials
Functional and cognitive impairment , depressive symptoms and social isolation are highly prevalent in head and neck cancer patients and associate with high risk of adverse health outcomes .
OBJECTIVES Older head and neck cancer patients are at increased risk for adverse health outcomes , but little is known about which geriatric assessment associates with poor outcome .
The aim is to study the association of functional or cognitive impairment , social environment and frailty with adverse health outcomes in patients with head and neck cancer .