Risk of early death after treatment with curative intent for head and neck squamous cell carcinoma: a retrospective population-based study

Authors

  • Mahmoud Bazina Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland; Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland https://orcid.org/0009-0002-0520-2958
  • Rayan Nikkilä Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland; Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer and Research, Helsinki, Finland; Department of Oral and Maxillofacial Surgery, Lahti Central Hospital, Päijät-Häme Joint Authority for Health and Wellbeing, Lahti, Finland
  • Aaro Haapaniemi Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
  • Leif Bäck Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
  • Sami Ventelä FICAN West Cancer Centre, Turku, Finland; Department for Otorhinolaryngology – Head and Neck Surgery, University of Turku and Turku University Hospital, Turku, Finland; 8 Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland
  • Antti Mäkitie Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland; Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden

DOI:

https://doi.org/10.2340/1651-226X.2025.42202

Keywords:

Mortality, Risk factors, Curative intent, Surgery, Radiotherapy, Chemoradiotherapy

Abstract

Background and purpose: Knowledge regarding the risk factors for early death in patients with head and neck squamous cell carcinoma (HNSCC) is scarce. This study aims to evaluate the rate of early death (during or within 6 months of treatment) and its associated risk factors in HNSCC patients treated with curative intent.

Materials and methods: A retrospective, population-based analysis of all HNSCC patients (n = 762) treated with curative intent at the Helsinki University Hospital (Helsinki, Finland) during 2012–2015 was conducted. Using the chi-square test, associations between categorical variables were assessed. Univariate and multivariate analyses were performed to identify independent factors for early death.

Results: The rate of early death was 10.1% with a median age of 70 years at diagnosis. Advanced stage, smoking > 40 pack-years, and heavy alcohol consumption were associated with increased odds of early death. Elevated thrombocyte levels > 380 (× 10⁹L) were observed more frequently in the early-death group when comparing the levels with the late-death group (p < 0.01). However, only age (odds ratio [OR] 1.05; 95% confidence interval [CI]:1.02–1.08), T4 class (OR 5.98; 95% CI: 2.60–13.74), N2 class (OR 2.98; 95% CI: 2.60–13.74), and N3 class (OR 12.24; 95% CI: 2.99–50.19) emerged as independent risk factors for early death.

Interpretation: Early death risk is increased in older patients and those with advanced-stage HNSCC. Elevated thrombocyte count requires further studies to assess its utility as a potential clinical marker.

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Published

2025-03-04

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Bazina, M., Nikkilä, R., Haapaniemi, A., Bäck, L., Ventelä, S., & Mäkitie, A. (2025). Risk of early death after treatment with curative intent for head and neck squamous cell carcinoma: a retrospective population-based study. Acta Oncologica, 64, 339–348. https://doi.org/10.2340/1651-226X.2025.42202

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Vol. 64 (2025): Acta Oncologica

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Copyright (c) 2025 Mahmoud Bazina, Rayan Nikkilä, Aaro Haapaniemi, Leif Bäck, Sami Ventelä, Antti Mäkitie

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