According to a study published in the November issue of the Archives of Otolaryngology – Head & Neck Surgery, one of the JAMA/Archives journals, among individuals with head and neck cancer, continued tobacco use as well as pain and poor overall quality of life seem to be linked to worse outcomes and increased mortality rate two years after being diagnosed.
The investigators explain:
“A conditional survival rate is the probability of surviving after having already lived for a certain length of time. This concept is important in the care of patients with head and neck cancer because it underlies the intuition of head and neck oncologists that mortality and recurrence rates are lower for patients further out from diagnoses.”
Trisha L. Thompson, B.S., and colleagues from the University of Iowa Hospital and Clinics, Iowa City, carried out an observational investigation of 276 individuals who survived two years following upper aerodigestive carcinoma diagnosis between September 2001 and September 2008.
The team obtained data using short-term queries as well as standard surveys. 59.9% of the 276 patients included in the examination previously smoked tobacco, while 11.4% currently smoked, two years after being diagnosed. Furthermore, 86% of survivors were consuming a full diet two years after diagnosis and 80.5% reported being pain free.
For all participants the 5-year traditional observed survival rate was 61.1% in comparison with the conditional rate of 90.8% for individuals who survived two years. In addition, for all participants the five-year traditional disease-specific rate was 69.8% in comparison with the conditional rate of 94.8% for individuals who survived two years.
Advanced stage of the disease as well as older age were linked to worse survival, even if death was a result of the cancer from all causes. Individuals were more likely to die from all causes if they experienced pain or poor overall quality of life, whereas individuals who continued to smoke after two years of being diagnoses were more likely to die as a result of their cancer.
The team report that the chances of death were four times lower for individuals who reported high overall quality of life, compared to individuals who reported poor overall quality of life. In addition, the likelihood of death was twice as high for patients who reported pain in comparison to those who experienced no pain.
Furthermore, the probability of death from cancer was four times higher among individuals who continued to use tobacco compared to patients who quit or have never used tobacco.
The researchers conclude:
“In addition to older age and advanced stage, which are known to have a negative effect on survival, the presence of pain and continued tobacco use should flag patients who might need longer and more intense follow-up care to improve their observed and disease-specific survival rates. This information is useful for clinicians in the development of management plans for patients who are transitioning from treatment into survivorship.”
Written by Grace Rattue