The Burden of Recurrent Head and Neck Squamous Cell Carcinoma Across the United Kingdom: Results From a National Snapshot Study.

Autor: Williamson A; Head and Neck Unit, The Royal Marsden Hospital, London, UK.; International Centre for Recurrent Head and Neck Cancer (IReC), The Royal Marsden Hospital, London, UK., Lim AE; Department of ENT Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland., Green F; Department of ENT Head and Neck Surgery, University College London Hospital, London, UK., Lee YK; Department of ENT Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK., Li L; Department of ENT Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland., Moen C; Department of ENT Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland., Vasanthan R; Frimley Health NHS Foundation Trust, Frimley, UK., Wharf O; Head and Neck Unit, The Royal Marsden Hospital, London, UK., Wong J; James Paget University Hospital NHS Foundation Trust, Great Yarmouth, UK., Paleri V; Head and Neck Unit, The Royal Marsden Hospital, London, UK.; International Centre for Recurrent Head and Neck Cancer (IReC), The Royal Marsden Hospital, London, UK.
Jazyk: angličtina
Zdroj: Head & neck [Head Neck] 2024 Dec 27. Date of Electronic Publication: 2024 Dec 27.
DOI: 10.1002/hed.28045
Abstrakt: Background: To investigate the management of recurrent head and neck squamous cell carcinoma (rHNSCC) and describe survival outcomes.
Methods: Post hoc subgroup analysis of a retrospective national observational cohort was conducted. All patients with rHNSCC who received a definitive treatment decision between September 1, 2021 and November 30, 2021 were included. Survival analysis was stratified according to subsite, primary versus recurrent disease, and surgical versus nonsurgical treatment.
Results: Data from 202 rHNSCC patients were derived from a cohort of 1488 patients submitted by 50 UK centers. Median age was 66 years (IQR 58-74), and 142 (70.3%) were male. The most common recurrence subsites were oropharynx (20.5%), oral cavity (19.5%), larynx (16.4%), and hypopharynx (14.9%). Ninety-three (48.4%) were managed curatively. Surgery was the most common treatment for laryngeal (59.4%), oral cavity (60.5%), hypopharyngeal (44.8%), and oropharyngeal (37.5%) cancers. Two-year overall (OS), disease-free (DFS), disease-specific (DSS), and local recurrence free survival (LRFS) were 41.1%, 39.1%, 42.2%, and 39.3%, respectively. rHNSCC treated with surgery had improved OS (p = 0.0005), DFS (p = 0.012), DSS (p = 0.0003), and LRFS (p = 0.007), over nonsurgical treatments. Compared to primary cancers, rHNSCC presents with more advanced T stage (p < 0.001) and distant metastasis (p < 0.001), receives less curative treatment (p < 0.001), and has worse survival outcomes (all p < 0.001). On multivariate analysis, salvage surgery, radiotherapy, and p16 status were independent prognostic factors of all survival outcomes.
Conclusions: Recurrent HNSCC is associated with high rates of incurable disease and worse survival than primary cancers. Surgery remains the most common curative treatment in rHNSCC, however future studies are necessary to improve patient selection and optimize outcomes following salvage treatment.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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