BackgroundThis 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.Patients and methodsWe 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.ResultsFive-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.ConclusionsOS 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.
È stata condotta unanalisi retrospettiva su 482 pazienti con diagnosi di tumore testa-collo arruolati presso l ospedale Agostino Gemelli di Roma. Lassociazione tra fattori demografici, clinici e comportamentali con la overall survival (OS), il rischio di ricorrenza ed il rischio di un secondo tumore primitivo è stata stimata usando gli Hazard Ratio (HR) e gli intervalli di confidenza al 95% (CIs). La OS considerando tutte le sedi tumorali è stata del 60%, mentre considerando le singole sedi tumorali è risultata del 49.0% per il cavo orale, 54.8% per lorofaringe, 50.0% per lipofaringe e 63.4% per la laringe. Unetà avanzata alla diagnosi (HR = 1.04; 95% CI: 1.02-1.05) ed un avanzato stadio del tumore (HR = 2.00; 95% CI: 1.41-2.84) sono risultati fattori significativamente associati con la OS. Il rischio di ricorrenza è risultato associato con il consumo di alcolici (HR = 1.73; 95% CI: 1.00-2.97). Il rischio di sviluppare un secondo tumore primitivo è risutlato associato con uno stadio avanzato del tumore primario (HR = 2.75; 95% CI: 1.39-5.44) e con laver fumato per più di 40 anni (HR = 3.68; 95% CI: 1.10-12.30). In conclusione abbiamo notato che la OS differisce tra le sedi tumorali del tumore testa-collo. Lo stadio tumorale è risultato essere associato sia con la OS che con il rischo di sviluppare un secondo tumore primitivo. Il consumo di alcol e di tabacco sono risultati essere fattori prognostici, rispettivamente, per la ricorrenza e per linsorgenza di un secondo tumore primitivo.
Background Several epidemiological studies have shown a positive association between adult height and cancer incidence. The only study conducted among women on mouth and pharynx cancer risk, however, reported an inverse association. This study aims to investigate the association between height and the risk of head and neck cancer (HNC) within a large international consortium of HNC. Methods We analyzed pooled individual-level data from 24 case-control studies participating in the International Head and Neck Cancer Epidemiology Consortium. Odds Ratios (ORs) and 95% Confidence Intervals (CIs) were estimated separately for men and women for associations between height and HNC risk. Educational level, tobacco smoking, and alcohol consumption were included in all regression models. Stratified analyses by HNC subsites were performed. Results This project included 17,666 cases and 28,198 controls. We found an inverse association between height and HNC (adjusted OR per 10 cm height =0.91, 95% CI 0.86–0.95 for men; adjusted OR=0.86, 95% CI 0.79–0.93 for women). In men, the estimated OR did vary by educational level, smoking status, geographic area, and control source. No differences by subsites were detected. Conclusions Adult height is inversely associated with HNC risk. As height can be considered a marker of childhood illness and low energy intake, the inverse association is consistent with prior studies showing that HNC occur more frequently among deprived individuals. Further studies designed to elucidate the mechanism of such association would be warranted.
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