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Trama A, Licitra L, Cavalieri S, Bonfarnuzzo S, Baili P, Ciarfella A, Parente P, Almadori G, Ansarin M, Bacigalupo A, Baumeister P, Baujat B, Bossi P, Cavalera E, Cercato MC, Dieleman F, Fakhry N, Ferraresi V, Gaino F, Galizia D, Halamkova J, Halme E, Hardillo J, Hofauer B, Kinloch E, Livi L, Locati LD, Mattheis S, Mercante G, Mirabile A, Molteni G, Orlandi E, Persio R, Sciallero S, Smeele L, Tagliabue M, Valentini V, Van Harpen C, Westphalen CB, Botta L. The observational clinical registry (cohort design) of the European Reference Network on Rare Adult Solid Cancers: The protocol for the rare head and neck cancers. PLoS One 2023; 18:e0283071. [PMID: 36928072 PMCID: PMC10019606 DOI: 10.1371/journal.pone.0283071] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/20/2022] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Care for head and neck cancers is complex in particular for the rare ones. Knowledge is limited and histological heterogeneity adds complexity to the rarity. There is a wide consensus that to support clinical research on rare cancer, clinical registries should be developed within networks specializing in rare cancers. In the EU, a unique opportunity is provided by the European Reference Networks (ERN). The ERN EURACAN is dedicated to rare adults solid cancers, here we present the protocol of the EURACAN registry on rare head and neck cancers (ClinicalTrials.gov Identifier: NCT05483374). STUDY DESIGN Registry-based cohort study including only people with rare head and neck cancers. OBJECTIVES to help describe the natural history of rare head and neck cancers;to evaluate factors that influence prognosis;to assess treatment effectiveness;to measure indicators of quality of care. METHODS Settings and participants It is an hospital based registry established in hospitals with expertise in head and neck cancers. Only adult patients with epithelial tumours of nasopharynx; nasal cavity and paranasal sinuses; salivary gland cancer in large and small salivary glands; and middle ear will be included in the registry. This registry won't select a sample of patients. Each patient in the facility who meets the above mentioned inclusion criteria will be followed prospectively and longitudinally with follow-up at cancer progression and / or cancer relapse or patient death. It is a secondary use of data which will be collected from the clinical records. The data collected for the registry will not entail further examinations or admissions to the facility and/or additional appointments to those normally provided for the patient follow-up. Variables Data will be collected on patient characteristics (eg. patient demographics, lifestyle, medical history, health status); exposure data (eg. disease, procedures, treatments of interest) and outcomes (e.g. survival, progression, progression-free survival, etc.). In addition, data on potential confounders (e.g. comorbidity; functional status etc.) will be also collected. Statistical methods The data analyses will include descriptive statistics showing patterns of patients' and cancers' variables and indicators describing the quality of care. Multivariable Cox's proportional hazards model and Hazard ratios (HR) for all-cause or cause specific mortality will be used to determine independent predictors of overall survival, recurrence etc. Variables to include in the multivariable regression model will be selected based on the results of univariable analysis. The role of confounding or effect modifiers will be evaluated using stratified analysis or sensitivity analysis. To assess treatment effectiveness, multivariable models with propensity score adjustment and progression-free survival will be performed. Adequate statistical (eg. marginal structural model) methods will be used if time-varying treatments/confounders and confounding by indication (selective prescribing) will be present. RESULTS The registry initiated recruiting in May 2022. The estimated completion date is December 2030 upon agreement on the achievement of all the registry objectives. As of October 2022, the registry is recruiting. There will be a risk of limited representativeness due to the hospital-based nature of the registry and to the fact that hospital contributing to the registry are expert centres for these rare cancers. Clinical Follow-up could also be an issue but active search of the life status of the patients will be guaranteed.
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Affiliation(s)
- Annalisa Trama
- Department of Epidemiology and Data Science, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- * E-mail:
| | - Lisa Licitra
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Stefano Cavalieri
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Simone Bonfarnuzzo
- Department of Epidemiology and Data Science, Data Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paolo Baili
- Department of Epidemiology and Data Science, Data Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Antonio Ciarfella
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Pablo Parente
- Department of Otorhinolaryngologyand Head and Neck Surgery, La Corunna University Hospital, Corunna, Spain
| | - Giovanni Almadori
- Department of Head-Neck Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, Rome, Italy
| | - Mohssen Ansarin
- Head and Neck Program and Division of Otolaryngology Head &Nech Surgery, European Institue of Oncology, Milan, Italy
| | - Almalina Bacigalupo
- Radioterapia Oncologica, IRCCS-AOU Ospedale Policlinico San Martino – IST, Genoa, Italy
| | - Philipp Baumeister
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Ludwig-Maximilians University, Munich, Germany
| | - Bertrand Baujat
- Otorhinolaryngology – Head and Neck surgery Department, APHP/Sorbonne Université, Hospital Tenon, Paris, France
| | - Paolo Bossi
- Medical Oncology Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, ASST Ospedali Civili, Brescia, Italy
| | - Elisa Cavalera
- Department Oncological Radiotherapy, "Vito Fazzi" Hospital, Lecce, Italy
| | - Maria Cecilia Cercato
- Epidemiology and Cancer Registry Unit – IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francois Dieleman
- Department of Head and Neck Surgical Oncology, UMC Utrecht Centre of Expertise for Head and Neck Cancer, UMC Utrecht Cancer Centre, Utrecht, the Netherlands
| | - Nicolas Fakhry
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, La Conception University Hospital, AP-HM, Aix Marseille University, Marseilles, France
| | - Virginia Ferraresi
- Sarcoma and Rare Tumours Departmental Unit-IRCCS Regina Elena National Cancer Institute-Rome, Rome, Italy
| | - Francesca Gaino
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Otorhinolaryngology - Head and Neck Surgery, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | | | - Jana Halamkova
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Faculty of Medicine, Department of Comprehensive Cancer Care, Masaryk University, Brno, Czech Republic
| | - Elina Halme
- Department of Otorhinolaryngology - Head and Neck Surgery, Tampere University Hospital, Tampere, Finland
| | - Jose Hardillo
- Department of otorhinolaryngology - Head and neck surgery, Erasmus University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | | | - Emma Kinloch
- Salivary Gland Cancer UK, International House, London, United Kingdom
| | - Lorenzo Livi
- Department of Oncological Radiotherapy, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Laura Deborah Locati
- Department of Medical Oncology of Head and Neck Tumours, ICS Maugeri SpA SB - IRCCS, Pavia, Italy
| | - Stefan Mattheis
- Ear, Nose and Throat Clinic, Essen Univerity Hospital, Essen, Germany
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Otorhinolaryngology - Head and Neck Surgery, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Aurora Mirabile
- Department of Medical Oncology, IRCCS San Raffaele, Milan, Italy
| | - Gabriele Molteni
- Otolaryngology Head and Neck Surgery Department, University Hospital, Verona, Italy
| | - Ester Orlandi
- Clinical Department, Radiotherapy Unit, National Centre for Oncological Hadrontherapy (Fondazione CNAO), Pavia, Italy
| | | | - Stefania Sciallero
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Ludi Smeele
- Department of Head and Neck surgery, Surgical Oncology Division, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Marta Tagliabue
- Department of Otolaryngology Head & Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Valentino Valentini
- Unit of Surgical Oncology, Maxillo Facial Reconstruction, Policlinico Umberto I, Rome, Italy
| | - Carla Van Harpen
- Department Medical Oncology, Radboud University Medical Centre, HB Nijmegen (HP 455), Nijmegen, the Netherlands
| | - Christoph Benedikt Westphalen
- Comprehensive Cancer Centre Munich & Department of Medicine III, German Cancer Consortium (DKTK), Ludwig Maximilian University of Munich, Munich, Germany
| | - Laura Botta
- Department of Epidemiology and Data Science, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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