Trends in all-cause five-year mortality after head and neck cancers diagnosed over a period of 33 years. Focus on estimated degree of association with human papillomavirus

Svahn, Malene Frøsig; Munk, Christian; Nielsen, Thomas Theis; Buchwald, Christian von; Frederiksen, Kirsten; Kjær, Susanne K.

doi:10.1080/0284186x.2016.1185148

Cited by 20 publications

(22 citation statements)

References 24 publications

(44 reference statements)

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“…11,12 Racial disparities have also been described in patients with HNC. 22,23 Generalized competing event (GCE) modeling is a useful and relatively novel method for analyzing effects of treatment and risk factors on outcomes. Some studies have demonstrated no difference in survival between women and men, 11,[19][20][21] whereas other studies have found differences in survival.…”

Section: Introductionmentioning

confidence: 99%

“…For example, Choi et al 11 reported that women had better survival, whereas others found that outcomes for men improved over time. 22,23 Generalized competing event (GCE) modeling is a useful and relatively novel method for analyzing effects of treatment and risk factors on outcomes. 21,24,25 This approach has been validated for several cancers, including head and neck, endometrial, prostate, and breast cancer.…”

Section: Introductionmentioning

confidence: 99%

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Undertreatment of women with locoregionally advanced head and neck cancer

Park

Alabaster

Shen

et al. 2019

Cancer

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BACKGROUND: It is difficult to predict whether a patient with head and neck cancer (HNC) is more likely to die of the cancer or another comorbidity. Competing event models can help to identify individual patients or groups of patients who may be undertreated or overtreated in clinical practice. METHODS: Patients with HNC (n = 884), aged 18 to 85 years and diagnosed from 2000 to 2015 with stage II to IVB disease according to the seventh edition of the American Joint Committee on Cancer system, were identified. With a generalized competing event (GCE) model that controlled for age, sex, tumor site, surgical treatment, and Charlson Comorbidity Index (CCI), the association between these factors and the relative hazard for cancer mortality was determined. Logistic regression models were used to estimate the odds of receiving platinum-based chemoradiotherapy or a less intensive therapy, with adjustments made for age, sex, tumor site, CCI, stage, smoking, and alcohol abuse history. RESULTS: Compared with men, women had an increased relative hazard ratio for death from HNC versus other causes, which was reported as an adjusted ω + ratio comparing women with men (ω + ratio, 1.95; 95% CI, 1.09-3.49), even though they were less likely to receive intensive chemoradiotherapy than men (adjusted odds ratio, 0.69; 95% CI, 0.48-0.99). CONCLUSIONS: These findings indicate that women in this cohort may be undertreated in clinical practice and potentially miss the opportunity for their HNC to be aggressively treated. This study supports the use of GCE models to identify patients who are potentially undertreated and may also help to guide future research in health disparities. Cancer 2019;125:3033-3039.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Undertreatment of women with locoregionally advanced head and neck cancer

Park

Alabaster

Shen

et al. 2019

Cancer

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“…Head and neck cancer squamous cell carcinomas (HNSCC) show a heterogeneous response to radiochemotherapy with loco-regional control and 5-year overall survival ranging from below 50% to 80% [1][2][3][4]. Few biomarkers related to tumor response to a therapy are already available for this tumor entity, for example: human papilloma virus infection [1][2], overexpression of epidermal growth factor receptor [5], tumor hypoxia or overexpression of cyclin D1 [6].…”

Section: Introductionmentioning

confidence: 99%

Comparison of PET and CT radiomics for prediction of local tumor control in head and neck squamous cell carcinoma

et al. 2017

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(2017). Material and methodsData from HNSCC patients (n=121) treated with definitive radiochemotherapy were used for model training. In total, 569 radiomic features were extracted from both contrast enhanced CT and 18F-FDG PET images in the primary tumor region.CT, PET and combined PET/CT radiomic models to assess local tumor control were trained separately. Five feature selection and three classification methods were implemented. The performance of the models was quantified using concordance index (CI) in 5-fold cross-validation in the training cohort. The best models, per image modality, were compared and verified in the independent validation cohort (n=51). The difference in CI was investigated using bootstrapping. Additionally, the observed and radiomics-based estimated probabilities of local tumor control were compared between two risk groups. ResultsThe feature selection using principal component analysis and the classification based on the multivariabale Cox regression with backward selection of the variables resulted in the best models for all image modalities (CICT=0.72, CIPET=0.74, CIPET/CT=0.77). Tumors more homogenous in CT density (decreased GLSZMsize_zone_entropy) and with a focused region of high FDG uptake (higher GLSZMSZLGE) indicated better prognosis. No significant difference in the performance of the models in the validation cohort was observed (CICT=0.73, CIPET=0.71, CIPET/CT=0.73). However, the CT radiomics based model overestimated the probability of tumor control in the poor prognostic group (predicted=68%, observed=56%). ConclusionBoth CT and PET radiomics showed equally good discriminative power for local tumor control modeling in HNSCC. However, CT-based predictions overestimated the local control rate in the poor prognostic validation cohort and thus we recommend to base the local control modeling on the 18F-FDG PET.

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“…Finally, individual‐level data on the clinical HPV status of the HNC cases was not available. Instead, we categorized the cases by topography into groups of anticipated degree of HPV‐association based on the available literature assessing HPV prevalence of different HNC sites . HPV is fully recognized as an etiological factor in oropharyngeal cancer, especially in cancer of the base of tongue and palatine tonsils with a reported HPV prevalence of more than 50% .…”

Section: Discussionmentioning

confidence: 99%

“…Instead, we categorized the cases by topography into groups of anticipated degree of HPVassociation based on the available literature assessing HPV prevalence of different HNC sites. 9,42,43 HPV is fully recognized as an etiological factor in oropharyngeal cancer, especially in cancer of the base of tongue and palatine tonsils with a reported HPV prevalence of more than 50%. 18,42 The HPV prevalence in oral and laryngeal cancer is lower (0-20%) 9,42 and the role of HPV in these cases is therefore more questionable.…”

Section: Discussionmentioning

confidence: 99%

Use of nonaspirin nonsteroidal anti‐inflammatory drugs and risk of head and neck cancer: A nationwide case–control study

Cour

Dehlendorff

Aalborg

et al. 2019

Intl Journal of Cancer

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Head and neck cancer (HNC) is the sixth most frequent malignancy with high mortality and substantial morbidity and hence there is a need for identification of preventive factors. Preclinical and observational studies have reported antineoplastic effects of nonaspirin nonsteroidal anti‐inflammatory drugs (NSAIDs), but studies of nonaspirin NSAID use and risk of HNC are sparse and with inconsistent results. We therefore conducted a register‐based case–control study nested in the entire Danish population. Cases (n = 12,389) comprised all Danish residents aged 30–84 years with a histologically verified primary HNC diagnosis during 2000–2015. Based on the literature, cases were categorized into four groups of anticipated association with human papillomavirus (HPV): strong, potential, no/weak and uncertain. Age‐ and sex‐matched population controls (n = 185,835) were selected by risk‐set‐sampling. We obtained information on filled prescriptions of nonaspirin NSAIDs, other drug use, comorbid conditions and socioeconomic parameters from nationwide Danish registries. Ever‐use (≥2 prescriptions) of nonaspirin NSAIDs was not associated with the overall risk of HNC after adjustment for potential confounders (odds ratio [OR]: 0.99, 95% confidence interval [CI]: 0.95–1.03). However, long‐term consistent use (≥5 years) was associated with a 25% reduction in HNC risk (OR: 0.75, 95% CI: 0.62–0.90). Stratified analyses by anticipated HPV‐association showed no material differences in estimates. In conclusion, ever‐use of nonaspirin NSAIDs was not associated with the risk of HNC with no apparent influence on the estimates by the anticipated HPV‐association. However, long‐term consistent use may be associated with a reduced risk of HNC and merits further investigation.

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Trends in all-cause five-year mortality after head and neck cancers diagnosed over a period of 33 years. Focus on estimated degree of association with human papillomavirus

Cited by 20 publications

References 24 publications

Undertreatment of women with locoregionally advanced head and neck cancer

Undertreatment of women with locoregionally advanced head and neck cancer

Comparison of PET and CT radiomics for prediction of local tumor control in head and neck squamous cell carcinoma

Use of nonaspirin nonsteroidal anti‐inflammatory drugs and risk of head and neck cancer: A nationwide case–control study

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