Clinicopathological profile and outcomes of treatment of head and neck cancer patients in a tertiary care center: a hospital-based prospective study (original) (raw)
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South Asian Journal of Cancer, 2018
advanced or recurrent cancers. The treatment of HNCs poses social and psychological challenges to patients as it leaves them disfigured and stigmatized. [3] As a result of the numerous anatomic sites and subsites from which HNC can arise and the diverse histologic types of tumors in the head and neck region, precise and dependable stratification of these tumors for the purpose of prediction of outcomes has been challenging. [5] However, the outcome of HNC in Nigeria is usually poor due to noted surmountable factors such as poverty, ignorance, late patient presentation, inaccessible and limited health facilities. [4] Studies have shown that improved knowledge of the epidemiology of different cancers plays a key role in health-care planning and can positively influence policymakers to improve their country's health policy. [6] This study therefore aims to review the epidemiologic features, the treatment and help us to understand the factors responsible for the outcome of treatment of our patients with HNC. It is hoped that the findings from this study will provide information to health policymakers in improving the management outcomes for our patients.
Journal of Oncology Pharmacy Practice, 2017
Purpose Patients with head and neck cancer are at risk for disease- and treatment-related toxicities that may be severe enough to require hospitalization. The risk factors associated with hospitalization in these patients are not well defined. Methods We conducted a single-center, retrospective observational study of patients with head and neck cancer receiving chemotherapy at an academic medical center infusion clinic in a one-year period. The primary objective was to characterize the head and neck cancer population at an academic medical center. Secondary objectives included describing the clinical and social factors associated with hospitalization. Results There were 109 patients with head and neck cancer included in the analysis. Of these patients, 38 (35%) were hospitalized. The factors that were significantly associated with hospitalization on univariable logistic regression were former alcohol abuse, being on a nonstandard of care chemotherapy regimen, and having a chemothera...
BMC Research Notes, 2015
Background: Head and neck cancer (HNC) is one of the most common cancers worldwide and its incidence is reported to be increasing in resource-limited countries. There is a paucity of published data regarding head and neck cancers in Tanzania, and Bugando Medical Centre in particular. This study describes the clinicopathological profile of HNC in our local setting and highlights the challenges in the management of this disease. Methods: This was a retrospective study of histopathologically confirmed cases of head and neck cancers treated at Bugando Medical Center between January 2009 and December 2013. Results: A total of 346 patients (M:F = 2.1:1) were studied representing 9.5 % of all malignancies. The median age of patients was 42 years. Cigarette smoking (76.6 %) and heavy alcohol consumption (69.9 %) were the most frequently identified risk factors for head and neck cancer. The majority of patients (95.9 %) presented late with advanced stages. Twenty-five (7.2 %) patients were HIV positive with a median CD4+ count of 244 cells/μl. The oral cavity (37.3 %) was the most frequent anatomical site affected. The most common histopathological type was carcinomas (59.6 %) of which 75.7 % were squamous cell carcinoma. A total of 196 (56.6 %) patients underwent surgical procedures for HNC. Radiotherapy and chemotherapy was reported in 9.5 and 16.8 % of patients, respectively. Only 2 (0.6 %) patients received chemo-radiation therapy. The mortality rate was 24.4 %. The overall 5-year survival rate (5-YSR) was 20.6 %. The predictors of overall 5-YSR were age of patient at diagnosis, stage of disease, extent of lymph node involvement, HIV seropositivity and CD4+ count <200 cells/μl (P < 0.001). Local recurrence was reported in 22 (23.4 %) patients and this was significantly associated with positive resection margins, stage of the tumor and presence of metastasis at diagnosis and non-adherence to adjuvant therapy (P < 0.001). Conclusion: Head and neck cancers are not uncommon at Bugando Medical Centre and show a trend towards a relative young age at diagnosis and the majority of patients present late with advanced stage cancer. Therefore, public enlightenment, early diagnosis, and effective cost-effective treatment and follow-up are urgently needed to improve outcomes of these patients in our environment.
Acta otorrinolaringologica espanola, 2018
The epidemiological characteristics of patients with head and neck cancer squamous cell carcinoma (HNSCC) have changed over recent years. The increase in life expectancy of the population, changed patterns of tobacco and alcohol use, and human papillomavirus infection (HPV) have brought about significant changes. The objective of the present study is to analyze the changes in the epidemiological and clinical characteristics of these patients over a 30-year period. Retrospective study of 5,123 patients with HNSCC treated over the period 1985-2017. We evaluated the existence of changes in the patterns of age, sex, tobacco and alcohol use, and location and extension of the tumours throughout the study period. HPV status was evaluated for patients with oropharyngeal carcinomas. Throughout the study period there was a significant increase in the mean age at presentation and in the percentage of women, and a decrease in the percentage of patients with history of high consumption of toxic ...
Head and neck cancers: Incidence, Epidemiological Risk, and Treatment Options
The term, 'head and neck cancer' is commonly used for many uncommon and infrequent types of cancer for which anatomical lesions generally arise in oral cavity (lip, gum and tongue having ICD 10 codes C00-06) Salivary glands (C07-C08) Throat (pharynx C09-C14), Larynx (C32), nasal cavity and Paranasal sinuses (C31-C31). Cancer of salivary glands, sarcomas and lymphomas are less frequent types of head and neck cancers. SCCHN accounts about 4% of all types of malignancies. Globally, it ranks 6th but in Pakistan it is 2nd most common malignancy. Complete head and neck examination, biopsy, chest imaging, Computed tomography (CT), Positron emission tomography-computed tomography (PET-CT) are most commonly used diagnostic tools for evaluation of head and neck carcinoma. Different treatment options for the management of Head and neck cancer are surgery, radiotherapy, chemotherapy and combination of these curative therapies. Radiotherapy of head and neck cancer produces oral complications by causing serious injuries to the salivary glands, mucosa of oral cavity and taste buds. This review briefly explain the types of head and neck cancer, its aetiology, staging, incidence rate in Pakistan and various treatment options as well. Keywords: Head and neck carcinoma, oral cancer, salivary gland cancer, cancer of Nasal cavity and paranasal sinus, larynx cancer and throat cancer.
Brazilian journal of otorhinolaryngology, 2019
INTRODUCTION Even with improved treatment outcomes with multimodality approaches, the question of what is the best initial treatment for locally advanced head and neck cancer still remains unanswered. OBJECTIVE To review the overall survival of a large cohort of head and neck cancer, patients with locally advanced head and neck cancer treated in a single institution. MATERIAL AND METHODS We studied a cohort of patients with locally advanced head and neck cancer treated in our institution in the last fifteen years. To gather a large sample of patients with adequate follow-up time, a cross-check between ours and Fundação Oncocentro de São Paulo databases were done. We included patients with head and neck cancer, clinical or pathological staging III or IV, treated with surgery followed by radiotherapy or surgery plus chemoradiation or radiotherapy alone or chemoradiation alone. RESULTS 796 patients with locally advanced head and neck cancer were included, 88% male, 44% age >60 years...
Head and neck cancer--Part 1: Epidemiology, presentation, and prevention
BMJ, 2010
Head and neck cancers include cancers of the upper aerodigestive tract (including the oral cavity, nasopharynx, oropharynx, hypopharynx, and larynx), the paranasal sinuses, and the salivary glands. Cancers at different sites have different courses and variable histopathological types, although squamous cell carcinoma is by far the most common. The anatomical sites affected are important for functions such as speech, swallowing, taste, and smell, so the cancers and their treatments may have considerable functional sequelae with subsequent impairment of quality of life. Decisions about treatment are usually complex, and they must balance efficacy of treatment and likelihood of survival, with potential functional and quality of life outcomes. Patients and their carers need considerable support during and after treatment. In this first part of a two article series, we review the common presentations of head and neck cancer. We also discuss common investigations and new diagnostic techniques, as well as briefly touching on screening and prevention. In this review, we have used evidence from national guidelines, randomised trials, and level II-III studies. We have limited our discussions to squamous cell carcinoma of the head and neck, which constitutes more than 85% of head and neck cancers.
Oral oncology, 2013
Head and neck cancer (HNC) is a disease of the upper aerodigestive tract and is one of the most frequently diagnosed cancers worldwide. A high rate of cancers involving the head and neck are reported across the Asian region, with notable variations between countries. Disease prognosis is largely dependent on tumor stage and site. Patients with early stage disease have a 60-95% chance of cure with local therapy. Early diagnosis and appropriate treatment are important to increase the likelihood of cure and survival. However, the majority of patients present with locally advanced disease and require multimodality treatment. This necessitates, a multidisciplinary approach which is essential to make appropriate treatment decisions, particularly with regards to tolerability, costs, available infrastructure and quality of life issues. Unfortunately, majority of the studies that dictate current practice have been developed in the west where diseases biology, patient population and available...
The Effect of Treating Institution on Outcomes in Head and Neck Cancer
Otolaryngology–Head and Neck Surgery, 2012
Objective Factors leading patients with head and neck cancer (HNCA) to seek radiation or chemoradiation in an academic center versus the community are incompletely understood, as are the effects of site of treatment on treatment completion and survival. Study Design Historical cohort study. Setting Tertiary academic center, community practices. Methods A historical cohort study was completed of patients with mucosal HNCA identified by International Classification of Disease, Ninth Revision ( ICD-9) codes receiving consultation at the authors’ institution from 2003 to 2008. Patients who received primary and adjuvant radiation at an academic center or in the community were included. The authors compared treatment completion rates and performed univariate and multivariate analyses of treatment outcomes. Results Of 388 patients, 210 completed treatment at an academic center and 145 at a community center (33 excluded, location unknown). Patients with HNCA undergoing radiation at an acade...