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Johns JD, Choe EJ, Chisolm PF, Pothast MJ, Randolph JR, Chou J, Maxwell JH. The impact of COVID-19 and vaccination status on outcomes in veterans with head and neck squamous cell carcinoma. Head Neck 2024; 46:1698-1705. [PMID: 38433326 DOI: 10.1002/hed.27714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/03/2024] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The impact of both COVID-19 infection and vaccination status on patients with head and neck squamous cell carcinoma (HNSCC) remains unknown. OBJECTIVE To determine the impact of COVID-19 infection and vaccination status on 60-day mortality, cardiovascular, and respiratory complications in patients with a prior diagnosis of HNSCC. METHODS This was a retrospective cohort study through the Veterans Affairs (VA) Corporate Data Warehouse of Veterans with HNSCC who were tested for COVID-19 during any inpatient VA medical center admission. A cohort of patients was created of Veterans with a diagnosis of HNSCC of the oral cavity,oropharynx, hypopharynx, larynx, and nasopharynx based on International Classification of Disease (ICD) codes. Data collected included clinical/demographic data, vaccination status, and incidence of 60-day mortality, 60-day cardiovascular complication (including myocardial infarction, venous thromboembolism, cerebrovascular accident), and 60-day respiratory complication (including acute respiratory failure, acute respiratory distress syndrome, and pneumonia). The interactions between COVID-19 infection, vaccination status, morbidity and mortality were investigated. RESULTS Of the 14 262 patients with HNSCC who were tested for COVID-19 during inpatient admission, 4754 tested positive (33.3%), and 9508 (67.7%) tested negative. Patients who tested positive demonstrated increased 60-day mortality (4.7% vs. 2.0%, respectively; p < 0.001), acute respiratory failure (ARF; 15.4% vs. 7.1%, p < 0.001), acute respiratory distress syndrome (ARDS; 0.9% vs. 0.2%, p < 0.001), and pneumonia (PNA; 20.0% vs. 6.4%, p < 0.001) compared to those who never tested positive, respectively. Patients who received COVID-19 vaccination between 2 weeks and 6 months prior to a positive test demonstrated decreased rates of ARF (13.2% vs. 16.0%, p = 0.034) and PNA (16.7% vs. 20.9%, p = 0.003) compared to the unvaccinated group. A logistic regression of patients with COVID-19 infections who died within 60 days was performed, with no significant survival advantage among patients vaccinated between 2 weeks and 6 months prior to the positive test. CONCLUSION COVID-19 infection may significantly increase rates of 60-day mortality and respiratory complications in patients with HNSCC. COVID-19 vaccination between 2 weeks and 6 months prior to infection may decrease severity of respiratory complications but did not show significant mortality benefits in this study. These data highlight the need for surveillance of respiratory infection and vaccination in this vulnerable population.
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Affiliation(s)
- James D Johns
- Department of Otolaryngology - Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Erica J Choe
- Georgetown University School of Medicine, Washington, DC, USA
| | - Paul F Chisolm
- Department of Otolaryngology - Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | | | - Jackson R Randolph
- Department of Otolaryngology - Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Jiling Chou
- Center for Biostatistics, Informatics, and Data Science, MedStar Health Research Institute, Hyattsville, Maryland, USA
| | - Jessica H Maxwell
- Department of Otolaryngology - Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
- Department of Surgery, Washington DC Veterans Affairs Medical Center, Washington, DC, USA
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Anzai Y, Chang CP, Rowe K, Snyder J, Deshmukh V, Newman M, Fraser A, Smith K, Date A, Galvao C, Monroe M, Hashibe M. Surveillance Imaging with PET/CT and CT and/or MRI for Head and Neck Cancer and Mortality: A Population-based Study. Radiology 2023; 307:e212915. [PMID: 36625743 PMCID: PMC10102644 DOI: 10.1148/radiol.212915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 08/21/2022] [Accepted: 11/09/2022] [Indexed: 01/11/2023]
Abstract
Background To the knowledge of the authors, no strong evidence supports surveillance imaging in patients with head and neck cancer (HNC). Purpose To investigate the association between surveillance imaging and mortality using a population-based study design with statewide cancer registry data, all-payer claims data, and health care facility data. Materials and Methods The retrospective population-based study identified patients with HNC diagnosed between January 2012 and December 2017. Current Procedural Terminology codes were used to search surveillance imaging procedures. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for mortality with adjustment for sex, ethnicity, age, health insurance status, cancer site, stage, and treatment. Results The study identified 1004 patients (mean age, 61 years ± 12 [SD]; 753 men), including 902 patients with squamous cell carcinoma (SCC) HNC and 102 patients with non-SCC. The effect of imaging on mortality among patients with SCC was not statistically significant when the entire sample was analyzed (HR, 0.76; 95% CI: 0.57, 1.02; P = .07). However, in stratified analyses by cancer stage, surveillance imaging was associated with lower mortality among patients with SCC for regionalized cancer stage (HR, 0.55; 95% CI: 0.36, 0.83; P = .005) and distant cancer stage (HR, 0.40; 95% CI: 0.19, 0.83; P = .01). Among patients with non-SCC, surveillance imaging was associated with lower mortality versus no surveillance imaging (HR, 0.19; 95% CI: 0.04, 0.94; P = .04). PET/CT was associated with lower mortality for patients with SCC (HR, 0.29; 95% CI: 0.09, 0.94; P = .04), and CT and/or MRI was associated with lower mortality for patients with non-SCC (HR, 0.11; 95% CI: 0.01, 0.94; P = .04). Conclusion Surveillance imaging was associated with lower mortality among patients with head and neck squamous cell carcinoma with regionalized or distant disease. The surveillance imaging protective association was observed up to 2 years after treatment completion. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Branstetter in this issue.
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Affiliation(s)
- Yoshimi Anzai
- From the Huntsman Cancer Institute, Salt Lake City, Utah (Y.A.,
C.P.C., M.H.); Division of Public Health, Department of Family &
Preventive Medicine (C.P.C., M.H.), Division of Otolaryngology, Department of
Surgery (M.M.), and Department of Radiology and Imaging Sciences (Y.A.),
University of Utah School of Medicine, 30N 1900 E, IA 71, Salt Lake City, UT
84102; Intermountain Healthcare, Salt Lake City, Utah (K.R., J.S.); University
of Utah Health Sciences Center, Salt Lake City, Utah (V.D., M.N.); and Pedigree
and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt
Lake City, Utah (A.F., K.S., A.D., C.G.)
| | - Chun-Pin Chang
- From the Huntsman Cancer Institute, Salt Lake City, Utah (Y.A.,
C.P.C., M.H.); Division of Public Health, Department of Family &
Preventive Medicine (C.P.C., M.H.), Division of Otolaryngology, Department of
Surgery (M.M.), and Department of Radiology and Imaging Sciences (Y.A.),
University of Utah School of Medicine, 30N 1900 E, IA 71, Salt Lake City, UT
84102; Intermountain Healthcare, Salt Lake City, Utah (K.R., J.S.); University
of Utah Health Sciences Center, Salt Lake City, Utah (V.D., M.N.); and Pedigree
and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt
Lake City, Utah (A.F., K.S., A.D., C.G.)
| | - Kerry Rowe
- From the Huntsman Cancer Institute, Salt Lake City, Utah (Y.A.,
C.P.C., M.H.); Division of Public Health, Department of Family &
Preventive Medicine (C.P.C., M.H.), Division of Otolaryngology, Department of
Surgery (M.M.), and Department of Radiology and Imaging Sciences (Y.A.),
University of Utah School of Medicine, 30N 1900 E, IA 71, Salt Lake City, UT
84102; Intermountain Healthcare, Salt Lake City, Utah (K.R., J.S.); University
of Utah Health Sciences Center, Salt Lake City, Utah (V.D., M.N.); and Pedigree
and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt
Lake City, Utah (A.F., K.S., A.D., C.G.)
| | - John Snyder
- From the Huntsman Cancer Institute, Salt Lake City, Utah (Y.A.,
C.P.C., M.H.); Division of Public Health, Department of Family &
Preventive Medicine (C.P.C., M.H.), Division of Otolaryngology, Department of
Surgery (M.M.), and Department of Radiology and Imaging Sciences (Y.A.),
University of Utah School of Medicine, 30N 1900 E, IA 71, Salt Lake City, UT
84102; Intermountain Healthcare, Salt Lake City, Utah (K.R., J.S.); University
of Utah Health Sciences Center, Salt Lake City, Utah (V.D., M.N.); and Pedigree
and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt
Lake City, Utah (A.F., K.S., A.D., C.G.)
| | - Vikrant Deshmukh
- From the Huntsman Cancer Institute, Salt Lake City, Utah (Y.A.,
C.P.C., M.H.); Division of Public Health, Department of Family &
Preventive Medicine (C.P.C., M.H.), Division of Otolaryngology, Department of
Surgery (M.M.), and Department of Radiology and Imaging Sciences (Y.A.),
University of Utah School of Medicine, 30N 1900 E, IA 71, Salt Lake City, UT
84102; Intermountain Healthcare, Salt Lake City, Utah (K.R., J.S.); University
of Utah Health Sciences Center, Salt Lake City, Utah (V.D., M.N.); and Pedigree
and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt
Lake City, Utah (A.F., K.S., A.D., C.G.)
| | - Michael Newman
- From the Huntsman Cancer Institute, Salt Lake City, Utah (Y.A.,
C.P.C., M.H.); Division of Public Health, Department of Family &
Preventive Medicine (C.P.C., M.H.), Division of Otolaryngology, Department of
Surgery (M.M.), and Department of Radiology and Imaging Sciences (Y.A.),
University of Utah School of Medicine, 30N 1900 E, IA 71, Salt Lake City, UT
84102; Intermountain Healthcare, Salt Lake City, Utah (K.R., J.S.); University
of Utah Health Sciences Center, Salt Lake City, Utah (V.D., M.N.); and Pedigree
and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt
Lake City, Utah (A.F., K.S., A.D., C.G.)
| | - Alison Fraser
- From the Huntsman Cancer Institute, Salt Lake City, Utah (Y.A.,
C.P.C., M.H.); Division of Public Health, Department of Family &
Preventive Medicine (C.P.C., M.H.), Division of Otolaryngology, Department of
Surgery (M.M.), and Department of Radiology and Imaging Sciences (Y.A.),
University of Utah School of Medicine, 30N 1900 E, IA 71, Salt Lake City, UT
84102; Intermountain Healthcare, Salt Lake City, Utah (K.R., J.S.); University
of Utah Health Sciences Center, Salt Lake City, Utah (V.D., M.N.); and Pedigree
and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt
Lake City, Utah (A.F., K.S., A.D., C.G.)
| | - Ken Smith
- From the Huntsman Cancer Institute, Salt Lake City, Utah (Y.A.,
C.P.C., M.H.); Division of Public Health, Department of Family &
Preventive Medicine (C.P.C., M.H.), Division of Otolaryngology, Department of
Surgery (M.M.), and Department of Radiology and Imaging Sciences (Y.A.),
University of Utah School of Medicine, 30N 1900 E, IA 71, Salt Lake City, UT
84102; Intermountain Healthcare, Salt Lake City, Utah (K.R., J.S.); University
of Utah Health Sciences Center, Salt Lake City, Utah (V.D., M.N.); and Pedigree
and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt
Lake City, Utah (A.F., K.S., A.D., C.G.)
| | - Ankita Date
- From the Huntsman Cancer Institute, Salt Lake City, Utah (Y.A.,
C.P.C., M.H.); Division of Public Health, Department of Family &
Preventive Medicine (C.P.C., M.H.), Division of Otolaryngology, Department of
Surgery (M.M.), and Department of Radiology and Imaging Sciences (Y.A.),
University of Utah School of Medicine, 30N 1900 E, IA 71, Salt Lake City, UT
84102; Intermountain Healthcare, Salt Lake City, Utah (K.R., J.S.); University
of Utah Health Sciences Center, Salt Lake City, Utah (V.D., M.N.); and Pedigree
and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt
Lake City, Utah (A.F., K.S., A.D., C.G.)
| | - Carlos Galvao
- From the Huntsman Cancer Institute, Salt Lake City, Utah (Y.A.,
C.P.C., M.H.); Division of Public Health, Department of Family &
Preventive Medicine (C.P.C., M.H.), Division of Otolaryngology, Department of
Surgery (M.M.), and Department of Radiology and Imaging Sciences (Y.A.),
University of Utah School of Medicine, 30N 1900 E, IA 71, Salt Lake City, UT
84102; Intermountain Healthcare, Salt Lake City, Utah (K.R., J.S.); University
of Utah Health Sciences Center, Salt Lake City, Utah (V.D., M.N.); and Pedigree
and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt
Lake City, Utah (A.F., K.S., A.D., C.G.)
| | - Marcus Monroe
- From the Huntsman Cancer Institute, Salt Lake City, Utah (Y.A.,
C.P.C., M.H.); Division of Public Health, Department of Family &
Preventive Medicine (C.P.C., M.H.), Division of Otolaryngology, Department of
Surgery (M.M.), and Department of Radiology and Imaging Sciences (Y.A.),
University of Utah School of Medicine, 30N 1900 E, IA 71, Salt Lake City, UT
84102; Intermountain Healthcare, Salt Lake City, Utah (K.R., J.S.); University
of Utah Health Sciences Center, Salt Lake City, Utah (V.D., M.N.); and Pedigree
and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt
Lake City, Utah (A.F., K.S., A.D., C.G.)
| | - Mia Hashibe
- From the Huntsman Cancer Institute, Salt Lake City, Utah (Y.A.,
C.P.C., M.H.); Division of Public Health, Department of Family &
Preventive Medicine (C.P.C., M.H.), Division of Otolaryngology, Department of
Surgery (M.M.), and Department of Radiology and Imaging Sciences (Y.A.),
University of Utah School of Medicine, 30N 1900 E, IA 71, Salt Lake City, UT
84102; Intermountain Healthcare, Salt Lake City, Utah (K.R., J.S.); University
of Utah Health Sciences Center, Salt Lake City, Utah (V.D., M.N.); and Pedigree
and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt
Lake City, Utah (A.F., K.S., A.D., C.G.)
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Hong J, Wei R, Nie C, Leonteva A, Han X, Du X, Wang J, Zhu L, Tian W, Zhou H. The risk and prognosis of secondary primary malignancy in lung cancer: a population-based study. Future Oncol 2021; 17:4497-4509. [PMID: 34402680 DOI: 10.2217/fon-2021-0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Aim: To assess and predict risk and prognosis of lung cancer (LC) patients with second primary malignancy (SPM). Methods: LC patients diagnosed from 1992 to 2016 were obtained through the Surveillance, Epidemiology, and End Results database. Standardized incidence ratios were calculated to evaluate SPM risk. Cox regression and competing risk models were applied to assess the factors associated with overall survival, SPM development and LC-specific survival. Nomograms were built to predict SPM probability and overall survival. Results & conclusion: LC patients remain at higher risk of SPM even though the incidence declines. Patients with SPM have a better prognosis than patients without SPM. The consistency indexes for nomograms of SPM probability and overall survival are 0.605 (95% CI: 0.598-0.611) and 0.644 (95% CI: 0.638-0.650), respectively.
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Affiliation(s)
- Jia Hong
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Rongrong Wei
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Chuang Nie
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Anastasiia Leonteva
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Xu Han
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Xinyu Du
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Jing Wang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Lin Zhu
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Wenjing Tian
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Haibo Zhou
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
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Silverman DA, Lin C, Tamaki A, Puram SV, Carrau RL, Seim NB, Eskander A, Rocco JW, Old MO, Kang SY. Respiratory and pulmonary complications in head and neck cancer patients: Evidence-based review for the COVID-19 era. Head Neck 2020; 42:1218-1226. [PMID: 32343013 PMCID: PMC7267530 DOI: 10.1002/hed.26217] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Pulmonary complications and infections frequently affect patients with head and neck squamous cell carcinoma (HNSCC). Common characteristics can predispose these patients to the development of severe respiratory illness, which may be particularly relevant during the 2019 coronavirus disease (COVID-19) pandemic. METHODS A scoping review was performed to assess the impact of pulmonary comorbidities and adverse respiratory outcomes in HNSCC patients. RESULTS Advanced age, history of tobacco and alcohol abuse, and cardiopulmonary comorbidities are significant risk factors for the development of adverse respiratory outcomes. Treatment toxicities from radiation or chemoradiation therapy significantly increase these risks. CONCLUSION Respiratory complications are a frequent cause of morbidity and mortality among HNSCC patients, and the COVID-19 pandemic may disproportionately affect this population. Interventions designed to decrease smoking and alcohol use, improve oral hygiene, and aggressively manage medical comorbidities are important to the long-term management and health of these patients.
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Affiliation(s)
- Dustin A Silverman
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Chen Lin
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Akina Tamaki
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Sidharth V Puram
- Department of Otolaryngology-Head and Neck Surgery and Department of Genetics, Washington University School of Medicine, Ear, Nose & Throat Center, St. Louis, Missouri, USA
| | - Ricardo L Carrau
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Nolan B Seim
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Antoine Eskander
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, USA
| | - James W Rocco
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Matthew O Old
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Stephen Y Kang
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
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