Outcomes and Prognostic Factors in Patients With Untreated Head and Neck Squamous Cell Carcinoma.

Objectives: Although several studies have reported the treatment prognosis in squamous cell carcinoma of the head and neck, few studies exist on the prognosis and mortality-related risk factors in untreated cases. This study aimed to determine the outcomes of patients with head and neck squamous cell carcinoma who underwent no treatment and investigate the associated factors.

Methods: This retrospective, single-institution study initially included 718 patients with head and neck cancer who visited our hospital between January 2015 and December 2021; 43 untreated patients were included in the final analysis. This study was conducted in Japan, where universal health insurance ensures access to treatment for all citizens.

Results: The median patient age was 79 years, with a predominance of male patients. The primary reasons for patients being untreated were patient refusal, dementia, and advanced age. The median survival time for untreated patients was 20.5 weeks, with 90% succumbing within one year of their first visit. Univariate analyses showed that an advanced clinical stage (stage IV) was a major determinant of survival. In patients with stage IV disease, living alone or without family support was the sole significant predictor of a poor prognosis.

Conclusions: Our results inform healthcare providers about the consequences of not providing treatment and patients regarding treatment choices.