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Lop J, Venegas MDP, Pujol A, Sauter B, Vásquez R, Casasayas M, Quer M, León X. Causes of long-term mortality in patients with head and neck squamous cell carcinomas. Eur Arch Otorhinolaryngol 2021; 279:3657-3664. [PMID: 34905065 PMCID: PMC9130168 DOI: 10.1007/s00405-021-07211-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/30/2021] [Indexed: 12/02/2022]
Abstract
Purpose After treatment of a head and neck squamous cell carcinoma (HNSCC), patients with an adequate control of the tumor have a decreased overall survival when compared to age- and gender-matched controls in the general population. The aim of our study was to analyze the causes of long-term mortality in patients with HNSCC. Methods We carried out a retrospective study of 5122 patients with an index HNSCC treated at our center between 1985 and 2018. We analyzed the survival considering three causes of death: mortality associated with the HNSCC index tumor, mortality associated with a second or successive neoplasm, and mortality associated with a non-cancer cause.
Results After the diagnosis of an HNSCC the most frequent cause of death is the head and neck tumor itself during the first 3.5 years of follow-up. Thereafter, mortality is more frequently associated with competing causes of death, such as second malignancies and non-cancer causes. Mortality associated with second and successive neoplasms was 2.3% per year, a percentage that was maintained constant throughout the follow-up. Likewise, mortality attributable to non-cancer causes was 1.6% per year, which also remained constant. There were differences in the mortality patterns according to the characteristics of the patients. Conclusion There are differences in the mortality patterns of patients with HNSCC depending on their characteristics. Knowledge of these patterns can help in the design of guidelines to improve the follow-up protocols of this group of patients to optimize the clinical cost-effectiveness. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-021-07211-8.
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Affiliation(s)
- Joan Lop
- Pathology Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María Del Prado Venegas
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, C/ Mas Casanovas, 90, 08041, Barcelona, Spain
| | - Albert Pujol
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, C/ Mas Casanovas, 90, 08041, Barcelona, Spain.
| | - Blanca Sauter
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, C/ Mas Casanovas, 90, 08041, Barcelona, Spain
| | - Rosselin Vásquez
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, C/ Mas Casanovas, 90, 08041, Barcelona, Spain
| | - María Casasayas
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, C/ Mas Casanovas, 90, 08041, Barcelona, Spain
| | - Miquel Quer
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, C/ Mas Casanovas, 90, 08041, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Xavier León
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, C/ Mas Casanovas, 90, 08041, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
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Effects of tumour stage, comorbidity and therapy on survival of laryngeal cancer patients: a systematic review and a meta-analysis. Eur Arch Otorhinolaryngol 2010; 268:165-79. [DOI: 10.1007/s00405-010-1395-8] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Accepted: 09/24/2010] [Indexed: 12/18/2022]
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Lidman D, Niklasson M. Survival and function in patients with tumours of the head and neck operated on and reconstructed with free flaps. ACTA ACUST UNITED AC 2008; 42:77-85. [PMID: 18335351 DOI: 10.1080/02844310701850538] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
From 1983 to 2003, 131 patients were operated on in the head and neck region with 139 free flaps. They were operated on using a team approach of ear, nose, and throat surgeons and plastic surgeons, and sometimes maxillofacial surgeons. The tumours were squamous cell carcinoma (SCC) 104 (80%), salivary gland cancer 13 (10%), sarcoma 5 (4%), basal cell carcinoma 4 (3%), and others 4 (3%). The staging of the primary intraoral SCC tumours (n=79) was 42% in stage II, 28% in stage III, and 30% in stage IV. The survival of patients with primary oral SCC was compared with a previously treated previous series that gave an increase in tumour-related five-year survival from 48% to 58%. Most flaps were radial forearm flaps (73%). Fifteen percent were vascularised bone transfers. A questionnaire was sent to patients who had had oral/oropharyngeal tumours to measure function and satisfaction, to which 47/49 responded. The results including ability to chew and swallow; speech was good, with a median score of 0.78 (range 1-0).
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Affiliation(s)
- Disa Lidman
- Department of Plastic Surgery, Hand Surgery and Burns, University Hospital, Linköping, Sweden.
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Stracci F, Canosa A, Minelli L, Petrinelli AM, Cassetti T, Romagnoli C, La Rosa F. Cancer mortality trends in the Umbria region of Italy 1978-2004: a joinpoint regression analysis. BMC Cancer 2007; 7:10. [PMID: 17227578 PMCID: PMC1781946 DOI: 10.1186/1471-2407-7-10] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2006] [Accepted: 01/16/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the present paper was to analyse cancer mortality in the Umbria region, from 1978 to 2004. Mortality trends depend on a number of factors including exposures, health system interventions, and possibly artefact (e.g. classification change, variations of data completeness). Descriptive data on mortality only allow for generation of hypotheses to explain observed trends. Some clues on the respective role of possible mortality determinants may be found comparing mortality with incidence and survival data. METHODS Mortality data for the periods 1978-1993 and 1994-2004 were supplied by the National Institute of Statistics (ISTAT) and the Regional Causes of Death Registry (ReNCaM) respectively. Sex and site-specific mortality time trends were analysed by the "joinpoint regression" method. RESULTS For all sites combined, in both sexes, the standardised rate was first increasing before the end of the eighties and decreasing thereafter. Gastric cancer mortality showed a different trend by gender; that is the rate constantly decreased over the period among females while, for males, it was first increasing up to 1985 and decreasing thereafter. Liver cancer trend showed a pattern similar to gastric cancer. Large bowel cancer showed a gender specific trend, that is it was increasing among males and stable among females. Also lung cancer mortality varied by gender: it started to decline after 1989 among males but was steadily increasing over the study period among women. A decreasing trend for female breast cancer mortality began in 1994. Prostate cancer mortality trend is the only one showing two significant joinpoints: mortality decreased up to 1990, then it increased up to 1998 and, finally, was decreasing. CONCLUSION Overall cancer mortality was decreasing in both sexes in Umbria and this favourable trend will probably continue and further improve since population screening against breast, cervix, and large bowel cancers were recently introduced. Besides gastric cancer, tobacco-related cancers and prostate cancer mainly contributed to mortality reduction in males, whereas breast cancer mainly contributed to declining mortality in females.
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Affiliation(s)
- Fabrizio Stracci
- Dpt. Medical-Surgical Special. & Public Health, Public Health Section, University of Perugia, Italy
- Department of Health, Regional Government of Umbria, Perugia, Italy
| | - Antonio Canosa
- Nominative Registry of Causes of Deaths, Umbrian Population Cancer Registry, Perugia, Italy
| | - Liliana Minelli
- Dpt. Medical-Surgical Special. & Public Health, Public Health Section, University of Perugia, Italy
| | - Anna Maria Petrinelli
- Nominative Registry of Causes of Deaths, Umbrian Population Cancer Registry, Perugia, Italy
- Dpt. Medical-Surgical Special. & Public Health, Public Health Section, University of Perugia, Italy
| | - Tiziana Cassetti
- Dpt. Medical-Surgical Special. & Public Health, Public Health Section, University of Perugia, Italy
| | - Carlo Romagnoli
- Nominative Registry of Causes of Deaths, Umbrian Population Cancer Registry, Perugia, Italy
- Department of Health, Regional Government of Umbria, Perugia, Italy
| | - Francesco La Rosa
- Nominative Registry of Causes of Deaths, Umbrian Population Cancer Registry, Perugia, Italy
- Dpt. Medical-Surgical Special. & Public Health, Public Health Section, University of Perugia, Italy
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