title: Risk factors for non-cancer health events in patients with head and neck squamous cell carcinoma.
abstract: BACKGROUND
  Cancer progression and non-cancer-related morbidities can affect the quality of life and survival of patients with head and neck squamous cell carcinomas (HNSCC). The aim of this study was to investigate the risk factors for the development of non-cancer health events (NCHEs) in HNSCC.
  
  
  METHODS
  The study involved 465 previously-untreated patients with HNSCC diagnosed between 2005 and 2009 at the Asan Medical Center. Non-cancer-associated morbidity was defined as readmission after treatment of HNSCC due to non-cancer-related causes. NCHEs were defined as the occurrence of non-cancer-associated morbidity or mortality. The incidence and risk factors for NCHEs were analyzed.
  
  
  RESULTS
  During the median follow-up of 47.6 months, non-cancer morbidity and mortality occurred in 83 (17.8%) and 25 patients (5.4%), respectively. Thirteen patients (52%) died from non-cancer-related causes with no previous admission for non-cancer causes. Multivariate analysis showed that the incidence of NCHEs was significantly associated with a Charlson comorbidity index ≥1 and stage III/IV disease (P < 0.001).
  
  
  CONCLUSIONS
  Patients with comorbidities and advanced diseases may be at higher risk of NCHEs. Because NCHEs are sometimes life-threatening, every effort should be made to avoid unexpected non-cancer-associated mortality in the HNSCC patients.
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan, College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul 138-736, Republic of Korea.
authors.forename: C H
authors.initials: CH
authors.lastname: Ryu
authors.forename: J-L
authors.initials: JL
authors.lastname: Roh
authors.forename: S-B
authors.initials: SB
authors.lastname: Kim
authors.forename: S-W
authors.initials: SW
authors.lastname: Lee
authors.forename: S-H
authors.initials: SH
authors.lastname: Choi
authors.forename: S Y
authors.initials: SY
authors.lastname: Nam
authors.forename: S Y
authors.initials: SY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D004358:Drug Therapy; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011878:Radiotherapy; D012307:Risk Factors; D016896:Treatment Outcome