Predictors of survival after head and neck squamous cell carcinoma in South America: the interchange study

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Author
Abrahão, Renata
Ribeiro Pinto, Luis Felipe
Nascimento de Carvalho, Flávia
Dias, Fernando Luis
Vasconcelos de Podestá, José Roberto
de Abreu, Priscila Marinho
Vilensky, Marta V.
Giglio, Raúl Eduardo
Oliveira, José Carlos
Siqueira Mineiro, Matinair
Ikeda, Mauro K.
Cuello, Mauricio A.
Munyo, Andres
Rodríguez Urrego, Paula Andrea
Hakim, José Antonio
Cayol, Federico
Figari, Marcelo Fernando
Gaborieau, Valérie
Keogh, Ruth H.
Brennan, Paul J.
Date
2020Published in
Journal of global oncology, 2378-9506, Vol. 6, 2020
Published for
American Society of Clinical Oncology
Source's URL
https://ascopubs.org/doi/full/10.1200/GO.20.00014Citación
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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.
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