Journal
ANNALS OF ONCOLOGY
Volume 28, Issue 11, Pages 2843-2851Publisher
OXFORD UNIV PRESS
DOI: 10.1093/annonc/mdx486
Keywords
head and neck cancer; prognostic factors; pooled analysis; epidemiology
Categories
Funding
- National Cancer Institute [R03CA113157]
- National Institute of Dental and Craniofacial Research [R03DE016611]
- Sao Paulo Research Foundation - FAPESP [GENCAPO 04/12054-9, 10/51168-0]
- Italian Association for Research on Cancer (AIRC) - IG [14220]
- Fondazione Veronesi [CUP: J54G13000430007]
- AIRC
- Italian Ministry of Education [PRIN 2009 X8YCBN]
- European Community [QLK1-CT-2001-00182]
- Scientific Research grant from the Ministry of Education, Science, Sports, Culture and Technology of Japan [17015052]
- Ministry of Health, Labor and Welfare of Japan [H20-002]
- PRECeDI project (Marie Sklodowska-Curie Research and Innovation Staff Exchange-RISE) [645740]
- Grants-in-Aid for Scientific Research [17015052] Funding Source: KAKEN
- Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [10/51168-0] Funding Source: FAPESP
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This study evaluated whether demographics, pre-diagnosis lifestyle habits and clinical data are associated with the overall survival (OS) and head and neck cancer (HNC)-specific survival in patients with HNC. We conducted a pooled analysis, including 4759 HNC patients from five studies within the International Head and Neck Cancer Epidemiology (INHANCE) Consortium. Cox proportional hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) were estimated including terms reported significantly associated with the survival in the univariate analysis. Five-year OS was 51.4% for all HNC sites combined: 50.3% for oral cavity, 41.1% for oropharynx, 35.0% for hypopharynx and 63.9% for larynx. When we considered HNC-specific survival, 5-year survival rates were 57.4% for all HNC combined: 54.6% for oral cavity, 45.4% for oropharynx, 37.1% for hypopharynx and 72.3% for larynx. Older ages at diagnosis and advanced tumour staging were unfavourable predictors of OS and HNC-specific survival. In laryngeal cancer, low educational level was an unfavourable prognostic factor for OS (HR = 2.54, 95% CI 1.01-6.38, for high school or lower versus college graduate), and status and intensity of alcohol drinking were prognostic factors both of the OS (current drinkers HR = 1.73, 95% CI 1.16-2.58) and HNC-specific survival (current drinkers HR = 2.11, 95% CI 1.22-3.66). In oropharyngeal cancer, smoking status was an independent prognostic factors for OS. Smoking intensity (> 20 cigarettes/day HR = 1.41, 95% CI 1.03-1.92) was also an independent prognostic factor for OS in patients with cancer of the oral cavity. OS and HNC-specific survival differ among HNC sites. Pre-diagnosis cigarette smoking is a prognostic factor of the OS for patients with cancer of the oral cavity and oropharynx, whereas pre-diagnosis alcohol drinking is a prognostic factor of OS and HNC-specific survival for patients with cancer of the larynx. Low educational level is an unfavourable prognostic factor for OS in laryngeal cancer patients.
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