Determinants of long‐term survival in a population‐based cohort study of patients with head and neck cancer from Scotland

Abstract

Background We investigated long‐term survival from head and neck cancer (HNC) using different survival approaches. Methods Patients were followed‐up from the Scottish Audit of Head and Neck Cancer. Overall survival and disease‐specific survival were calculated using the Kaplan–Meier method. Net survival was calculated by the Pohar‐Perme method. Mutually adjusted Cox proportional hazards models were used to determine the predictors of survival. Results A total of 1820 patients were included in the analyses. Overall survival at 12 years was 26.3% (24.3%, 28.3%). Disease‐specific survival at 12 years was 56.9% (54.3%, 59.4%). Net survival at 12 years was 41.4% (37.6%, 45.1%). Conclusion Determinants associated with long‐term survival included age, stage, treatment modality, WHO performance status, alcohol consumption, smoking behavior, and anatomical site. We recommend that net survival is used for long‐term outcomes for HNC patients—it disentangles other causes of death, which are overestimated in overall survival and underestimated in disease‐specific survival.

Inequality in survival of people with head and neck cancer: Head and Neck 5000 cohort study

“…Therefore, we were only able to investigate the inequality in survival using all‐cause mortality. However, due to the short‐term follow‐up period of this study, it is likely that a high proportion of deaths would be attributed to HNC, and therefore all‐cause and disease‐specific mortality results would be unlikely to be substantially different 48 …”

Five- and ten-year survival of squamous cell carcinoma of the head and neck in northern Thailand: a multivariate analysis

“…1 In 2018, there were more than 830,000 new cases (the tenth most common cancer) and more than 430,000 deaths due to head and neck cancer worldwide (the sixth most common cause of cancer mortality), 2 with the highest incidence in South and Southeast Asia. 3,4 The well-known main risk factors are tobacco and alcohol consumption, [5][6][7] but there are other specific risk factors such as betel nut chewing for oral cavity cancer, [8][9][10] and human papillomavirus infection for oropharyngeal cancer. [11][12][13] Although SCC is histologically similar, the specific site of the primary cancer can affect the outcome of treatment due to the dissimilar risk of metastasis to the cervical regional lymphatic channel and haematologic dissemination.…”

“…[11][12][13] Although SCC is histologically similar, the specific site of the primary cancer can affect the outcome of treatment due to the dissimilar risk of metastasis to the cervical regional lymphatic channel and haematologic dissemination. 7,[14][15][16][17][18] The 5-year overall survival (OS) rate of SCCHN at 24-65% differs among continents and even within the same country and has been linked to the prevalence of risk factors. 1,7,[15][16][17][18][19][20] In general, the options of curative treatment at an early stage of the cancer are either surgery or radical radiotherapy, which have resulted in similar oncological outcomes.…”

“…7,[14][15][16][17][18] The 5-year overall survival (OS) rate of SCCHN at 24-65% differs among continents and even within the same country and has been linked to the prevalence of risk factors. 1,7,[15][16][17][18][19][20] In general, the options of curative treatment at an early stage of the cancer are either surgery or radical radiotherapy, which have resulted in similar oncological outcomes. 21,22 There are many options for the treatment of locally advanced stage cancer, such as surgery with postoperative radiotherapy, concurrent chemoradiotherapy, induction chemotherapy followed by concurrent chemoradiation or a combination of radiotherapy with targeted therapy.…”

“…14,[21][22][23] Most patients present with locoregionally advanced disease and already have diminishing health, thus making them unsuitable for intensive curative treatment. 5,7,[15][16][17][18][24][25][26][27][28][29] In Thailand, SCCHN is a common type of cancer predominantly affecting males. 15 According to the National Cancer Registry, primary cancer of oral cavity is the most common SCCHN followed by the larynx, oropharynx and hypopharynx.…”