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Original Article
Nov 2011

Factors Associated With Mortality in 2-Year Survivors of Head and Neck Cancer

Author Affiliations

Author Affiliations: University of Iowa Carver College of Medicine (Ms Thompson) and Department of Otolaryngology–Head and Neck Surgery, University of Iowa Hospital and Clinics (Drs Pagedar, Hynds Karnell, and Funk), Iowa City.

Arch Otolaryngol Head Neck Surg. 2011;137(11):1100-1105. doi:10.1001/archoto.2011.179

Objectives To determine conditional survival rates of 2-year survivors of head and neck cancer and to identify risk factors of increased mortality.

Design Prospective, observational study conducted from September 1, 2001, through September 31, 2008.

Setting Tertiary care institution.

Patients Two hundred seventy-six patients who survived 2 years after the diagnosis of their upper aerodigestive carcinoma.

Intervention Patients prospectively provided health-related information.

Main Outcome Measures The primary outcomes were observed (death from all causes) and disease-specific (cancer-related) survival for 2-year survivors.

Results Five-year observed (90.8%) and disease-specific (94.8%) survival rates were 29.7 and 25.0 percentage points higher, respectively, than rates calculated for all patients at diagnosis. Older age and advanced stage were associated with poorer survival, whether death was due to the cancer or from all causes. Patients with pain or poor overall quality of life at 2 years were more likely to die from all causes, whereas those still smoking 2 years after diagnosis were more likely to die from their cancer.

Conclusions In addition to older age and advanced stage, pain, poor overall quality of life, and tobacco use 2 years after diagnosis characterize patients who might need longer and more intense follow-up care to improve their observed and disease-specific survival. This information is useful in developing management plans for patients transitioning from a focus on cancer surveillance into survivorship.