A New Approach to Survival Analysis of Head and Neck Squamous Cell Carcinoma (original) (raw)
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British journal of cancer, 1996
The prognostic weight of histological and biological factors was compared with that of known clinical prognostic factors in a population of 108 consecutive previously untreated patients with head and neck squamous cell carcinoma. Parameters studied were: tumour vascularisation, mitotic index, histological differentiation, nuclear grade, keratinisation, desmoplasia, growth pattern, inflammation, tumour emboli in peripheral vessels, keratins 6, 13, 19 immunohistochemical expression, cytofluorometric ploidy and S-phase. In multivariate analysis (Cox), only age and nodal status had a significant impact on the overall survival, whereas T stage was the only significant factor associated with locoregional failure. The cumulative incidence of metastases was correlated not only with age, T and N stage, but also with histological differentiation. All the other histological and biological factors studied failed to provide further prognostic information. These findings may help to select patien...
Critical Reviews in Oncology/Hematology, 2019
The pattern of clinical behaviour and response to treatment of recurrent and/or metastatic head and neck squamous cell carcinoma is heterogeneous. Treatment strategies that can be employed vary from potentially curative salvage surgery and re-irradiation to palliative systemic therapies and best supportive care. The advent of new therapeutic options, in terms of more sophisticated surgical approaches and techniques, highly conformal and precise radiation techniques and immunotherapy may offer improved control of disease and longer survival. Moreover, the epidemiological changes during the last decades, including the increase of human papilloma virus-related oropharyngeal primary tumors, are also reflected in the recurrent and metastatic setting. In this complex context the identification of predictive and prognostic factors is urgently needed to tailor treatment, to increase its efficacy, and to avoid unnecessary toxicities. A better knowledge of prognosis may also help the patients and caregivers in decision making on the optimal choice of care. The purpose of our review is to highlight the current evidence and shortcomings in this field.
European journal of epidemiology, 2018
Recurrence and second primary cancer (SPC) continue to represent major obstacles to long-term survival in head and neck cancer (HNC). Our aim was to evaluate whether established demographics, lifestyle-related risk factors for HNC and clinical data are associated with recurrence and SPC in HNC. We conducted a multicentre study by using data from five studies members of the International Head and Neck Cancer Epidemiology consortium-Milan, Rome, Western Europe, Sao Paulo, and Japan, totalling 4005 HNC cases with a median age of 59 (interquartile range 52-67). Multivariate hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for recurrence and SPC. During follow-up, 1161 (29%) patients had recurrence and 343 (8.6%) developed SPC. Advanced tumour stage was associated with increased risk of recurrence in HNC overall (HR = 1.76, 95% CI 1.41-2.19). Women with laryngeal cancer had a reduced risk of recurrence compared to men (HR = 0.39, 95% CI: 0.24-0.74). Concerning predic...
Head and neck squamous cell carcinoma : Mansoura 10 years experience
2005
Head and neck (H&N) cancers are the sixth most prevalent cancers in the world with squamous cell carcinoma (SCC) constituting around 90% of it. One hundred and eighty eight patients with H&N SCC were treated at Mansoura University Hospital in the period from January 1990 to December 1999 inclusive. For those 188 cases we analyzed their clinicoepidemiologic data, survival, prognostic factors, patterns of failure and toxicity of therapy. Unfortunately 75.5% of the cases presented in advanced stages. The median eventfree survival duration was 14 months, while the median overall survival duration was 22 months. The 5-year eventfree survival and overall survival were 45% and 53%, respectively. On multivariate analysis for event-free survival, only performance status and grade were significant (p ≤0.05). On the other hand multivariate analysis for overall survival found only performance status and stage to be significant (p ≤0.05). Local failure exceeded in incidence both nodal and distan...
Survival and Recurrence Rate in Patients with Head and Neck Cancer and Associated Prognostic Factors
International Journal of Cancer Management, 2018
Background: Head and Neck cancer (HNC) is the 6th most common cancer worldwide. Its recurrence probability is known as the greatest obstacle to prolong survival rate. Objectives: This study was conducted to assess survival and recurrence rate of HNC and their associated risk factors. Methods: This retrospective cohort study was conducted on 179 HNC patients, who were diagnosed from April 2007 to November 2013 in Tehran, Iran. Two outcomes were simultaneously analyzed: time between diagnosis and disease recurrence or interrecurrences; the time between diagnosis and death or end of the study. Kaplan-Meier curve, log-rank test, and general joint frailty model were utilized to data analysis, using Stata 11.0 and R. Results: From 179 patients, 52.5% experienced relapse at least once and 15.6% of cases deceased. The survival rate in 12-, 24-, and 60-month were 94.4, 83.1%, and 55.4%, respectively. The median of survival time was 60.92 (1.1-72.9) months, which was longer in patients with relapse (63.62 versus 24.16). Advanced stage and the age older than 50 significantly increased the risk of death about 4-fold and 3-fold (P = 0.007, P = 0.014). Moreover, the initial treatment of surgery + radiotherapy + chemotherapy had significantly raised the hazard of relapse (P < 0.001). Conclusions: The percentage of deceased patients in relapse group was more than non-relapses, but the median of survival time in them was longer. Early detection can prevent recurrent events and the premature death of HNC patients.
Iranian Journal of Cancer Prevention, 2015
Background: Evidences about survival of the patients with head and neck squamous cell carsinoma (HNSCC) have been scant in our region. Objectives: The aim of current study was to determine clinico-pathological and treatment-related factors, influencing outcome of these patients. Patients and Methods: We have reviewed all patients with a new diagnosis of HNSCC admitted between 2008 and 2014 in "Jorjani Cancer Center", Tehran, Iran. Overall survival (OS) and event free survival (EFS) of the patients, and their relation with demographic and clinicopathological factors have been analyzed. Results: Among 119 included patients, 90 were male and 29 were female with mean age of 58 years. Larynx was the most common primary tumor site (55% of all patients). With a median follow-up period of 28 months, OS and EFS of the study patients was 61.2% and 52.4%, respectively. Tumor stage was the only parameter has significantly influenced the patients' OS. Patients with normal BMIs had significantly higher mean EFS compared with patients with bellow or above normal BMIs. Surgical treatment modalities have resulted in the same prognosis as non-surgical approaches. Conclusions: Our study seems to be the first that investigated outcome of Iranian patients with head and neck cancer and its influencing factors.
Conditional survival in head and neck squamous cell carcinoma
Cancer, 2007
BACKGROUND. Survival statistics for patients with head and neck squamous cell carcinomas (HNSCC) are commonly calculated from the time of diagnosis. The less commonly employed conditional survival (CS) analyzes survival for patients who have survived a period of time after diagnosis. Useful prognostic information for cancer survivors is provided by CS analysis. Estimated baseline CS parameters for HNSCC were sought using large-scale cancer registry data.
Prognostic and Predictive Factors in Advanced Head and Neck Squamous Cell Carcinoma
International Journal of Molecular Sciences
Head and neck squamous cell carcinoma (HNSCC) is a heterogeneous disease arising from the mucosa of the upper aerodigestive tract. Despite multimodality treatments approximately half of all patients with locally advanced disease relapse and the prognosis of patients with recurrent or metastatic HNSCC is dismal. The introduction of checkpoint inhibitors improved the treatment options for these patients and pembrolizumab alone or in combination with a platinum and fluorouracil is now the standard of care for first-line therapy. However, approximately only one third of unselected patients respond to this combination and the response rate to checkpoint inhibitors alone is even lower. This shows that there is an urgent need to improve prognostication and prediction of treatment benefits in patients with HNSCC. In this review, we summarize the most relevant risk factors in the field and discuss their roles and limitations. The human papilloma virus (HPV) status for patients with oropharyn...
The impact of comorbidity on survival in patients with squamous cell carcinoma of the head and neck
Head & Neck
Background. In North America, cigarette smoking and/or alcohol consumption not only cause head and neck cancer, they also cause many of the other diseases, illnesses, and conditions, also known as comorbidities, frequently found in our patients. Comorbidities can influence treatment decision making and treatment outcome. The aim of this study is to quantify the increased risk of comorbidity in our patients.
Serologic determinants of survival in patients with squamous cell carcinoma of the head and neck
The American Journal of Surgery, 1990
Specific circulating serum proteins may reflect unique properties governing the growth and progression of head and neck cancers, One hundred three previously untreated patients with squamous cell carcinoma of the head and neck were prospectively evaluated for serum IgA, lgG, and lgM and Clq-binding macromolecules, lmmunoglobulins were assessed by the immunoturbidimetric technique. Clq-binding maeromolecules (CIqBM) were measured utilizing the iodine-125 assay of Zubler et al (J Immunol 1976; 116: 232-5). Neither the level of serum immunoglobulins nor CIqBM values were correlated with the primary site, AJC (American Joint Committee on Cancer) stage of disease, or size of primary lesion. Likewise, comparison of serum lgA with ClqBM values demonstrated that these laboratory parameters were independent variables (r = 0.15 by Pearson linear regression). Univariate statistical analysis, utilizing the Cox proportional hazard model, showed serum lgA and ClqBM values to each contribute significantly to the ability to predict survival in patients with advanced squamous cell carcinoma of the head and neck (p = 0.01 and 0.003, respectively). Furthermore, multivariate analysis reveals that both ClqBM and serum lgA levels contribute significantly to the hazards model beyond staging in predicting survival (p <0.001). Predictive results were most apparent in patients with stage IV disease and related to the probability of both regional and distant metastatic recurrences. Conversely, serologic analysis provided no information in patients who were staged early. These results support pretreatment multiparametric serologic analysis of patients with squamous cell carcinoma of the head and neck.