Prognostic Impact of Malignant Wounds in Patients With Head and Neck Cancer - Secondary Analysis of a Prospective Cohort Study

Sep 21, 2026

Uploaded by Theodore

Secondary analysis of a prospective cohort study evaluates whether malignant wounds influence outcomes in patients with head and neck cancer treated in 23 Japanese palliative care units. Malignant wounds, associated with ulcerating or fungating lesions, were examined against survival using log-rank comparisons. Among 29 patients with head and neck cancer and malignant wounds, overall survival was significantly shorter than in those without (median 19.0 vs 32.0 days; P=0.046). Results support malignant wounds as a negative prognostic indicator.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Introduction

Methods

Results

Conclusion

Keywords

Corresponding Author

Data Availability Statement

Background

Prognostic Impact of Malignant Wounds in Patients With Head and Neck Cancer: Secondary Analysis of a Prospective Cohort Study Cancer Control Volume 31: 1–7 © The Author(s) 2024 Article reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions) [DOI: 10.1177/10732748241274216](DOI: 10.1177/10732748241274216)[ ](DOI: 10.1177/10732748241274216)[journals.sagepub.com/home/ccx](journals.sagepub.com/home/ccx) Shigemasa Takamizawa 1 􀀁, Hiroto Ishiki1, Yuma Takeda 1, Sayaka Arakawa 1, Naruaki Kawasaki 1, Isseki Maeda2, Naosuke Yokomichi3 􀀁, Takashi Yamaguchi4 􀀁 , Hiroyuki Otani5, Tatsuya Morita3,6, Eriko Satomi 1, and Masanori Mori3 Abstract Introduction: Malignant wounds are lesions caused by metastasis from distant primary cancers or by direct invasion of the cutaneous structures of a primary cancer, and are most common in patients with breast or head and neck cancers. Malignant wounds not only cause physical symptoms, but also affect survival. Recognizing prognosis in terminal-stage cancer patients is necessary for both patients and health care providers. The prognostic impact of malignant wounds in patients with head and neck cancer has been poorly investigated. Methods: This is a secondary analysis of the results of a prospective cohort study that investigated the dying process in patients with advanced cancer in 23 palliative care units in Japan. The primary outcome of this study was the prognostic impact of malignant wounds in patients with head and neck cancer. The difference in survival between patients with head and neck cancer who had malignant wounds and those who did not was compared using the log-rank test. Results: Of 1896 patients admitted to palliative care units, 68 had head and neck cancer, and 29 of these had malignant wounds. Overall survival was signiﬁcantly shorter in patients with malignant wounds than that in those without (median: 19.0 days vs 32.0 days, P = 0.046). Conclusion: Patients with head and neck cancer who had malignant wounds had worse overall survival than those who did not. Keywords cohort studies, head and neck neoplasms, malignant wound, palliative care, palliative prognostic index, prognosis Received May 17, 2024. Received revised July 9, 2024. Accepted for publication July 23, 2024. 1 Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan 2Department of Palliative Care, Senri-Chuo Hospital, Toyonaka, Japan 3Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan 4Department of Palliative Medicine, Kobe University, Kobe, Japan 5Department of Palliative and Supportive Care, St. Mary’s Hospital, Kurume, Japan 6Research Association for Community Health, Hamamatsu, Japan Corresponding Author: Hiroto Ishiki, Department of Palliative Medicine, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo 104-0045, Japan. Email: [h.ishiki@03.alumni.u-tokyo.ac.jp](h.ishiki@03.alumni.u-tokyo.ac.jp) Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as speciﬁed on the SAGE and Open Access pages ([https://us.sagepub.com/en-us/nam/open-access-at-sage](https://us.sagepub.com/en-us/nam/open-access-at-sage)). Data Availability Statement included at the end of the article Introduction Cancer is a leading cause of death globally.1,2 Alleviating symptoms such as fatigue, loss of appetite, pain, and dyspnea is crucial for patients with advanced cancer.3 Malignant wounds, which are also referred to as ulcerating tumors or fungating wounds,4 are lesions caused by metastasis from distant primary cancers, or by direct invasion of a pr

FAQs

What are malignant wounds in this study?

They are lesions caused by metastasis from distant primary cancers or by direct invasion into cutaneous structures, including ulcerating or fungating tumors.

How were prognosis differences assessed between patients with and without malignant wounds?

Survival between groups was compared using the log-rank test.

What did the study find about overall survival?

Overall survival was significantly shorter in patients with malignant wounds (median 19.0 days) than in those without (median 32.0 days; P=0.046).

Sep 21, 2026

Uploaded by Theodore