Tumour stage and gender predict recurrence and second primary malignancies in head and neck cancer: a multicentre study within the INHANCE consortium

Abstract

Recurrence and second primary cancer (SPC) continue to represent major obstacles to long-term survival in head and neck cancer (HNC). Our aim was to evaluate whether established demographics, lifestyle-related risk factors for HNC and clinical data are associated with recurrence and SPC in HNC. We conducted a multicentre study by using data from five studies members of the International Head and Neck Cancer Epidemiology consortium-Milan, Rome, Western Europe, Sao Paulo, and Japan, totalling 4005 HNC cases with a median age of 59 (interquartile range 52-67). Multivariate hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for recurrence and SPC. During follow-up, 1161 (29%) patients had recurrence and 343 (8.6%) developed SPC. Advanced tumour stage was associated with increased risk of recurrence in HNC overall (HR = 1.76, 95% CI 1.41-2.19). Women with laryngeal cancer had a reduced risk of recurrence compared to men (HR = 0.39, 95% CI: 0.24-0.74). Concerning predictors of SPC, advanced age (HR = 1.02; 95% CI: 1.00-1.04) and alcohol consumption (> 1 drink per day, HR = 2.11; 95% CI: 1.13-3.94) increased the risk of SPC among patients with laryngeal cancer. Additionally, women were at higher risk of SPC, in HNC overall group (HR = 1.68; 95% CI: 1.13-2.51) and oropharyngeal cancer group (HR = 1.74; 95% CI: 1.02-2.98). Tumour stage and male gender (larynx only) were positive predictors of cancer recurrence in HNC patients. Predictors of SPC were advanced age and alcohol use among laryngeal cancer cases, and female gender for oropharyngeal and HNC overall.

The risk of second primary tumors in head and neck cancer: A systematic review

“…Our search criteria identified, 5540 papers and after removal of duplicates, 61 papers were selected for data review and are summarized in Table . Most of the studies were retrospective.…”

Prognostic factors in laryngeal squamous cell carcinoma

“…In a review, the ratio of glottic to supraglottic tumors was 2.12:1 in men and 0.56:1 in women, which remains highly significant . In a multicenter study comprising 4005 patients with head and neck cancer, women with laryngeal cancer had a reduced risk for recurrence compared with men (HR = 0.39, 95% CI: 0.24‐0.74) . In a series of 1252 consecutive patients with LSCC who all were treated with primary radiotherapy, multivariate analyses revealed that male gender was a significant factor in predicting locoregional failure, death from cancer, and death from all causes…”

“…The degree of a neoplasm's differentiation should not be confused with its histological grading. Factors allowing for better assessment of the histological grading of malignancies include: degree of structural differentiation, cellular anaplasia or pleomorphism, mitotic activity index (frequency and abnormality of mitotic figures), expansive or infiltrative growth, inflammatory response to the tumor, necrosis, and lymphatic and blood vessel invasion.…”

Targeting SKA3 suppresses the proliferation and chemoresistance of laryngeal squamous cell carcinoma via impairing PLK1–AKT axis-mediated glycolysis

“…The onset of LSCC is occult, accounting for 60% incidence of patients with advanced stages (clinical stages 3 and 4) upon diagnosis 1 , 6 . Furthermore, those with the highest risk of recurrence are usually diagnosed in the first 2–3 years after surgery 7 . Moreover, secondary primary tumors are often diagnosed in patients whose initial lesion is controlled 8 .…”