title: Early death among head and neck cancer patients.
abstract: OBJECTIVE
  Management of advanced head and neck cancer (HNC) is characterized by high mortality. Furthermore, the treatment involves significant burden to patients and high costs to healthcare systems. Recognizing the risks of early death in patients with a high probability of noncurable disease is important for each individual treatment decision-making. It is thus critical to consider the benefits and side-effects of the planned treatment in relation to the expected survival and to discuss these factors with the patient. However, only few studies have documented early death in HNC patients, that is, during the first posttreatment 6 months. We performed a systematic literature review to find the incidence of this phenomenon and to outline the probable cause.
  
  
  RESULTS
  Early mortality in patients with HNC can be explained either by direct effect of malignant disease, may be related to comorbidities, or secondary to the treatment. These factors act together resulting in expected or unexpected early death.
  
  
  CONCLUSIONS
  The present review provides information on the mechanisms leading to early phase mortality (<6 months) after management of HNC. It also reports the incidence of this phenomenon among Finnish and Swedish patient populations.
authors.affiliation: aDepartment of Otorhinolaryngology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden bFinnish Cancer Registry, Helsinki, Finland cDepartment of Clinical Sciences, Division of Ear, Nose and Throat Diseases, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden dDepartment of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland eDepartment of Surgical Sciences, ENT, Uppsala University, Uppsala, Sweden *Antti Mäkitie and Göran Laurell contributed equally to the writing of this article.
authors.forename: Lovisa
authors.initials: L
authors.lastname: Farnebo
authors.forename: Nea
authors.initials: N
authors.lastname: Malila
authors.forename: Antti
authors.initials: A
authors.lastname: Mäkitie
authors.forename: Göran
authors.initials: G
authors.lastname: Laurell
mesh_terms: D015897:Comorbidity; D003657:Decision Making; D005387:Finland / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006801:Humans; D015994:Incidence; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology