Clinical features and prognostic factors in patients with head and neck cancer: Results from a multicentric study

Cancer Epidemiol. 2015 Jun;39(3):367-74. doi: 10.1016/j.canep.2015.02.004. Epub 2015 Mar 11.

Abstract

Background: The purpose of this study is to evaluate whether demographics, lifestyle habits, clinical data and alcohol dehydrogenase polymorphisms rs1229984 and rs1573496 associated with first primary head and neck (HNC) are associated with overall survival, recurrence, and second primary cancer (SPC).

Methods: We conducted a follow-up study in five centres including 801 cases. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for overall survival, recurrence and SPC.

Results: Five-years overall survival was 62% for HNC cases, 55% for oral cavity, 53% for oropharynx, 41% for hypopharynx, and 71% for larynx. Predictors of survival were older ages (HR=1.18 for 5 years increase; CI: 1.07-1.30), higher tumour stage (HR=4.16; CI: 2.49-6.96), and high alcohol consumption (HR=3.93; CI: 1.79-8.63). A combined therapy (HR=3.29; CI: 1.18-9.13) was associated with a worst prognosis for oral cavity cancer. The only predictor was higher tumour stage (HR=2.25; CI: 1.26-4.03) for recurrence, and duration of smoking (HR=1.91; CI: 1.00-3.68) for SPC. ADH1B rs1229984 polymorphism HRs for HNC and oesophageal cancer death and for alcohol related cancer death were 0.67 (95% CI: 0.42-1.08), and 0.64 (95% CI: 0.40-1.03), respectively.

Conclusions: The survival expectation differs among HNC sites. Increasing age and stage, and high alcohol consumption were unfavourable predictors of HNC survival overall. Duration of tobacco consumption before the first primary tumour was a risk factor for SPC.

Keywords: Head and neck cancer; Recurrence; Second primary; Survival.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alcohol Dehydrogenase / genetics
  • Alcohol Drinking / adverse effects
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / genetics*
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / pathology*
  • Humans
  • Male
  • Middle Aged
  • Polymorphism, Single Nucleotide
  • Proportional Hazards Models
  • Risk Factors
  • Smoking / adverse effects

Substances

  • Alcohol Dehydrogenase