Predictors of Survival After Head and Neck Squamous Cell Carcinoma in South America: The InterCHANGE Study.

Autor: Abrahão R; Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France.; Division of Hematology/Oncology and Center for Healthcare Policy Research, University of California, Davis, Sacramento, CA., Perdomo S; Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France.; Institute of Nutrition, Genetics, and Metabolism Research, Faculty of Medicine, Universidad El Bosque, Bogotá, Colombia.; University Hospital Foundation Santa Fe de Bogotá, Bogotá, Colombia., Pinto LFR; National Cancer Institute, Rio de Janeiro, Brazil., Nascimento de Carvalho F; National Cancer Institute, Rio de Janeiro, Brazil., Dias FL; National Cancer Institute, Rio de Janeiro, Brazil., de Podestá JRV; Santa Rita de Cassia Hospital (AFECC), Vitória, Brazil., Ventorin von Zeidler S; Biotechnology Postgraduation Program, Federal University of Espírito Santo, Vitória, Brazil., Marinho de Abreu P; Biotechnology Postgraduation Program, Federal University of Espírito Santo, Vitória, Brazil., Vilensky M; Angel Roffo Institute of Oncology, Buenos Aires, Argentina., Giglio RE; Angel Roffo Institute of Oncology, Buenos Aires, Argentina., Oliveira JC; Araújo Jorge Hospital, Goiania, Brazil., Mineiro MS; Araújo Jorge Hospital, Goiania, Brazil., Kowalski LP; A.C. Camargo Cancer Center, São Paulo, Brazil., Ikeda MK; A.C. Camargo Cancer Center, São Paulo, Brazil., Cuello M; Hospital de Clínicas, Montevideo, Uruguay., Munyo A; Hospital de Clínicas, Montevideo, Uruguay., Rodríguez-Urrego PA; University Hospital Foundation Santa Fe de Bogotá, Bogotá, Colombia., Hakim JA; University Hospital Foundation Santa Fe de Bogotá, Bogotá, Colombia., Suarez-Zamora DA; University Hospital Foundation Santa Fe de Bogotá, Bogotá, Colombia., Cayol F; Italiano Hospital, Buenos Aires, Argentina., Figari MF; Italiano Hospital, Buenos Aires, Argentina., Oliver J; Italiano Hospital, Buenos Aires, Argentina., Gaborieau V; Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France., Keogh RH; Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom., Brennan P; Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France., Curado MP; A.C. Camargo Cancer Center, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: JCO global oncology [JCO Glob Oncol] 2020 Mar; Vol. 6, pp. 486-499.
DOI: 10.1200/GO.20.00014
Abstrakt: 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.
Databáze: MEDLINE
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