Predictors of Survival After Head and Neck Squamous Cell Carcinoma in South America: The InterCHANGE Study

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Predictors of Survival After Head and Neck Squamous Cell Carcinoma in South America: The InterCHANGE Study


JournaljCO Global oncology
Publication date – Mar – 2020
Authors – Renata Abrahão MD, MSc, PhD, Sandra Perdomo PhD, Luis Felipe Ribeiro Pinto PhD, Flavia Nascimento de Carvalho MSc, Fernando Luis Dias MD, PhD, Jose Roberto V. de Podesta MD, Sandra Ventorin von Zeidler PhD, Priscila Marinho de Abreu PharmD, MSc, Marta Vilensky BSc, Raul Eduardo Giglio MD, Jose Carlos Oliveira PhD, Matinair Siqueira Mineiro RN, Luiz P. Kowalski MD, PhD, Mauro K. Ikeda PhD, Mauricio Cuello MD, Andres Munyo MD, Paula A. Rodrıguez-Urrego MD, Jose Antonio Hakim, MD ´ 4 ; David Alfonso Suarez-Zamora MD, Federico Cayol, MD, Marcelo Fernando Figari MD, Javier Oliver PhD, Valerie Gaborieau DUT, Ruth H. Keogh DPhil, Paul Brennan, PhD and Maria Paula Curado, PhD, MD on behalf of the InterCHANGE Group
KeywordsHead and neck squamous cell carcinoma, predictors of survival, South America
Open access – Yes
SpecialityENT surgery, Surgical oncology
World region South America
Country: Argentina, Brazil, Colombia, Uruguay
Language – English
Submitted to the One Surgery Index on May 31, 2020 at 3:02 pm
Abstract:

PURPOSE
Head and neck squamous cell carcinoma (HNSCC) incidence is high in South America, where recent data on survival are sparse. We investigated the main predictors of HNSCC survival in Brazil, Argentina, Uruguay, and Colombia.

METHODS
Sociodemographic and lifestyle information was obtained from standardized interviews, and clinicopathologic data were extracted from medical records and pathologic reports. The Kaplan-Meier method and Cox regression were used for statistical analyses.

RESULTS
Of 1,463 patients, 378 had a larynx cancer (LC), 78 hypopharynx cancer (HC), 599 oral cavity cancer (OC), and 408 oropharynx cancer (OPC). Most patients (55.5%) were diagnosed with stage IV disease, ranging from 47.6% for LC to 70.8% for OPC. Three-year survival rates were 56.0% for LC, 54.7% for OC, 48.0% for OPC, and 37.8% for HC. In multivariable models, patients with stage IV disease had approximately 7.6 (LC/HC), 11.7 (OC), and 3.5 (OPC) times higher mortality than patients with stage I disease. Current and former drinkers with LC or HC had approximately 2 times higher mortality than never-drinkers. In addition, older age at diagnosis was independently associated with worse survival for all sites. In a subset analysis of 198 patients with OPC with available human papillomavirus (HPV) type 16 data, those with HPV-unrelated OPC had a significantly worse 3-year survival compared with those with HPV-related OPC (44.6% v 75.6%, respectively), corresponding to a 3.4 times higher mortality.

CONCLUSION
Late stage at diagnosis was the strongest predictor of lower HNSCC survival. Early cancer detection and reduction of harmful alcohol use are fundamental to decrease the high burden of HNSCC in South America.

OSI Number – 20464
PMID – 32213095

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