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

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.

• Autores: Abrahão, Renata; Perdomo Lara, Sandra Janneth; Ribeiro Pinto, Luis Felipe; Nascimento de Carvalho, Flávia; Dias, Fernando Luis; Vasconcelos de Podestá, José Roberto; von Zeidler, Sandra Ventorin; de Abreu, Priscila Marinho; Vilensky, Marta V.; Giglio, Raúl Eduardo; Oliveira, José Carlos; Siqueira Mineiro, Matinair; Kowalski, Luiz Paulo; Ikeda, Mauro K.; Cuello, Mauricio A.; Munyo, Andres; Rodríguez Urrego, Paula Andrea; Hakim, José Antonio; Suarez-Zamora, David A.; Cayol, Federico; Figari, Marcelo Fernando; Oliver, Javier; Gaborieau, Valérie; Keogh, Ruth H.; Brennan, Paul J.; Curado, Maria Paula
• Tipo de recurso: Article of journal
• Fecha de publicación: 2020
• Institución: Universidad El Bosque
• Repositorio: Repositorio U. El Bosque
• Idioma: eng
• OAI Identifier: oai:repositorio.unbosque.edu.co:20.500.12495/3397
• Acceso en línea: http://hdl.handle.net/20.500.12495/3397; http://ascopubs.org/doi/full/10.1200/GO.20.00014; https://repositorio.unbosque.edu.co
• Palabra clave: Neoplasias laríngeas; Mortalidad; Informes de casos
• Rights: openAccess
• License: Attribution-NonCommercial-NoDerivatives 4.0 International