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Koyama S, Tabuchi T, Morishima T, Miyashiro I. Alcohol consumption and 10-year mortality in oral and pharyngeal cancer. Cancer Epidemiol 2024; 89:102540. [PMID: 38325027 DOI: 10.1016/j.canep.2024.102540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/29/2023] [Accepted: 01/21/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Previous studies on the association of alcohol drinking with the prognosis of patients with oral and pharyngeal cancer are scarce and conflicting. Most previous studies are surveys from Europe, and examined up to 5 years of overall survival. We therefore evaluated the association between alcohol consumption and 10-year mortality among oral and pharyngeal cancer patients in Japan. METHODS 2626 eligible cancer patients diagnosed between 1975 and 2010, identified through a hospital-based cancer registry in Japan, were followed up for up to 10 years. Alcohol consumption was used to divide subjects into five categories: non-drinker, ex-drinker, light (≤23 g/day of ethanol), moderate (23 < and ≤ 46 g/day of ethanol), and heavy drinker (> 46 g/day of ethanol), respectively. A Cox proportional hazards regression model was conducted to evaluate the association of alcohol consumption with 10-year all-cause mortality adjusting for sex, age, primary site, cancer stage, number of multiple cancers, surgery, radiotherapy, chemotherapy, smoking status and diagnosis year. RESULTS Ex-drinker and heavy drinker cases had a significantly higher risk of death than non-drinkers (ex-drinker; HR=1.59; 95% CI,1.28-1.96, heavy drinker; HR=1.36; 95% CI,1.14-1.62). Heavy drinkers had a significantly higher risk of death than non-drinkers in both men and women (men; HR=1.35; 95% CI,1.10-1.65, women; HR=2.52; 95% CI,1.41-4.49). CONCLUSIONS Among oral and pharyngeal cancer patients, an elevated risk of death was observed for heavy drinkers who consumed more than 46 g/day of ethanol compared with non-drinkers. In addition, this relationship was observed in both men and women.
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Affiliation(s)
- Shihoko Koyama
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, Osaka 541-8567, Japan.
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, Osaka 541-8567, Japan
| | - Toshitaka Morishima
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, Osaka 541-8567, Japan
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, Osaka 541-8567, Japan
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2
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Kotevski DP, Smee RI, Vajdic CM, Field M. Empirical comparison of routinely collected electronic health record data for head and neck cancer-specific survival in machine-learnt prognostic models. Head Neck 2023; 45:365-379. [PMID: 36369773 PMCID: PMC10100433 DOI: 10.1002/hed.27241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 09/21/2022] [Accepted: 11/02/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Knowledge of the prognostic factors and performance of machine learning predictive models for 2-year cancer-specific survival (CSS) is limited in the head and neck cancer (HNC) population. METHODS Data from our facilities' oncology information system (OIS) collected for routine practice (OIS dataset, n = 430 patients) and research purposes (research dataset, n = 529 patients) were extracted on adults diagnosed between 2000 and 2017 with squamous cell carcinoma of the head and neck. RESULTS Machine learning demonstrated excellent performance (area under the curve, AUC) in the whole cohort (AUC = 0.97, research dataset), larynx cohort (AUC = 0.98, both datasets), and oropharynx cohort (AUC = 0.99, both datasets). Tumor site and T classification were identified as predictors of 2-year CSS in both datasets. Hypothyroidism and fitness for operation were further identified in the research dataset. CONCLUSIONS Datasets extracted from an OIS for routine clinical practice and research purposes demonstrated high utility for informing 2-year head and neck CSS.
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Affiliation(s)
- Damian P Kotevski
- Department of Radiation Oncology, Prince of Wales Hospital and Community Health Services, Sydney, New South Wales, Australia.,Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Robert I Smee
- Department of Radiation Oncology, Prince of Wales Hospital and Community Health Services, Sydney, New South Wales, Australia.,Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Department of Radiation Oncology, Tamworth Base Hospital, Tamworth, New South Wales, Australia
| | - Claire M Vajdic
- Centre for Big Data Research in Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Matthew Field
- South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
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3
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Hamilton DW, O'Hara J, Rajgor A, Selby G, Anderson M, Keltie K, Parker R, Teare D, Patterson J, Jones TM, Sharp L. Precision medicine in laryngeal cancer: protocol of the laryngeal cancer cohort (LARCH). BMJ Open 2023; 13:e067561. [PMID: 36639211 PMCID: PMC9843189 DOI: 10.1136/bmjopen-2022-067561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Laryngeal cancer disproportionately affects socioeconomically disadvantaged patients. Treatment can render a patient nil by mouth or in need of a permanent tracheostomy. In the past 30 years, survival has remained at best static and at worst it has declined. Currently, there is no method of prognosticating how a patient will respond to treatment.The LARyngeal Cancer coHort (LARCH) aims to establish how survival and quality-of-life outcomes compare between surgery and (chemo)radiotherapy in early and advanced laryngeal cancer and how the presenting features of laryngeal cancer influence oncological, functional and quality-of-life outcome. METHODS AND ANALYSIS This study is the first enhanced laryngeal cancer disease cohort. In the initial phase, we aim to deliver a prospective cohort study of 150 patients in 8 centres over a 3-year period.Patient, tumour, quality-of-life and laryngeal functional data will be collected from patients with squamous cell carcinoma of the larynx at baseline, 6, 12 and 24 months. Multiple logistic regression analyses will be used to quantify locoregional control and identify factors associated with control overall and by treatment modality and identify factors associated with quality of life overall and by treatment modality. ETHICS AND DISSEMINATION Most interventions take place as part of routine care, with LARCH providing a mechanism for recording this data centrally. When successfully recruiting in the North of England, we plan to roll out LARCH nationwide; in the future, LARCH can be used as a trial platform in the disease. The results will be submitted for publication in high-impact international peer-reviewed journals and presented to scientific meetings. Access to the anonymised LARCH dataset by other researchers will be publicised and promoted. TRIAL REGISTRATION NUMBER ISRCTN27819867.
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Affiliation(s)
- David Winston Hamilton
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- ENT, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - James O'Hara
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- ENT, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Amarkumar Rajgor
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- ENT, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | | | - Mhairi Anderson
- Newcastle Joint Research Office, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Kim Keltie
- Northern Medical Physics and Clinical Engineering, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Rosalyn Parker
- Northern Medical Physics and Clinical Engineering, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Dawn Teare
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Joanne Patterson
- Liverpool Head and Neck Centre, University of Liverpool, Liverpool, UK
| | - Terry M Jones
- Liverpool Head and Neck Centre, University of Liverpool, Liverpool, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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4
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Kotevski DP, Smee RI, Vajdic CM, Field M. Machine Learning and Nomogram Prognostic Modeling for 2-Year Head and Neck Cancer-Specific Survival Using Electronic Health Record Data: A Multisite Study. JCO Clin Cancer Inform 2023; 7:e2200128. [PMID: 36596211 DOI: 10.1200/cci.22.00128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE There is limited knowledge of the prediction of 2-year cancer-specific survival (CSS) in the head and neck cancer (HNC) population. The aim of this study is to develop and validate machine learning models and a nomogram for the prediction of 2-year CSS in patients with HNC using real-world data collected by major teaching and tertiary referral hospitals in New South Wales (NSW), Australia. MATERIALS AND METHODS Data collected in oncology information systems at multiple NSW Cancer Centres were extracted for 2,953 eligible adults diagnosed between 2000 and 2017 with squamous cell carcinoma of the head and neck. Death data were sourced from the National Death Index using record linkage. Machine learning and Cox regression/nomogram models were developed and internally validated in Python and R, respectively. RESULTS Machine learning models demonstrated highest performance (C-index) in the larynx and nasopharynx cohorts (0.82), followed by the oropharynx (0.79) and the hypopharynx and oral cavity cohorts (0.73). In the whole HNC population, C-indexes of 0.79 and 0.70 and Brier scores of 0.10 and 0.27 were reported for the machine learning and nomogram model, respectively. Cox regression analysis identified age, T and N classification, and time-corrected biologic equivalent dose in two gray fractions as independent prognostic factors for 2-year CSS. N classification was the most important feature used for prediction in the machine learning model followed by age. CONCLUSION Machine learning and nomogram analysis predicted 2-year CSS with high performance using routinely collected and complete clinical information extracted from oncology information systems. These models function as visual decision-making tools to guide radiotherapy treatment decisions and provide insight into the prediction of survival outcomes in patients with HNC.
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Affiliation(s)
- Damian P Kotevski
- Department of Radiation Oncology, Prince of Wales Hospital and Community Health Services, Sydney, New South Wales, Australia.,Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Robert I Smee
- Department of Radiation Oncology, Prince of Wales Hospital and Community Health Services, Sydney, New South Wales, Australia.,Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Department of Radiation Oncology, Tamworth Base Hospital, Tamworth, New South Wales, Australia
| | - Claire M Vajdic
- Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Matthew Field
- South Western Sydney Clinical Campus, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia.,South Western Sydney Cancer Services, NSW Health, Sydney, Sydney, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
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Creaney G, McMahon AD, Ross AJ, Bhatti LA, Paterson C, Conway DI. Head and neck cancer in the UK: what was the stage before COVID-19? UK cancer registries analysis (2011-2018). Br Dent J 2022; 233:787-793. [PMID: 36369569 PMCID: PMC9650177 DOI: 10.1038/s41415-022-5151-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022]
Abstract
Introduction People who present with more advanced stage head and neck cancer (HNC) are associated with poorer outcomes and survival. The burden and trends of advanced stage HNC are not fully known at the population level. The UK national cancer registries routinely collect data on HNC diagnoses.Aims To describe trends in stage of diagnosis of HNCs across the UK before the COVID-19 pandemic.Methods Aggregated HNC incidence data were requested from the national cancer registries of the four UK countries for the ten most recent years of available data by subsite and American Joint Commission on Cancer stage at diagnosis classification. Additionally, data for Scotland were available by age group, sex and area-based socioeconomic deprivation category.Results Across the UK, rates of advanced stage HNC had increased, with 59% of patients having advanced disease at diagnosis from 2016-2018. England had a lower proportion of advanced disease (58%) than Scotland, Wales or Northern Ireland (65-69%) where stage data were available. The completeness of stage data had improved over recent years (87% by 2018).Conclusion Prior to the COVID-19 pandemic, diagnoses of HNC at an advanced stage comprised the majority of HNCs in the UK, representing the major challenge for the cancer healthcare system.
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Affiliation(s)
- Grant Creaney
- Clinical Lecturer in Dental Public Health, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
| | - Alex D McMahon
- Reader (Dental School), School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Alastair J Ross
- Senior Lecturer in Human Factors in Health Care, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | | | - Claire Paterson
- Consultant Clinical Oncologist, Beatson West of Scotland Cancer Centre, NHS Greater Glasgow and Clyde, UK
| | - David I Conway
- Professor of Dental Public Health,, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
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Taziki M, Rajaei S, Firouzei G, Hashemzadeh F, Rajabalian M, Mansoury M, Sedaghat S, Ghahraman F, Ghasemi-Kebria F, Weiderpass E, Roshandel G. Five-year relative survival and determinants of excess mortality in patients with head and neck and thyroid cancers: A population-based study from Golestan province, Northern Iran. Cancer Epidemiol 2022; 80:102247. [PMID: 36081275 DOI: 10.1016/j.canep.2022.102247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/28/2022] [Accepted: 08/29/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND We aimed to assess relative survival (RS) and determinants of excess mortality rate in patients with head and neck squamous cell carcinomas (HNSCC) and thyroid cancer in Golestan province, Northern Iran. METHODS We recruited new primary HNSCC and thyroid cancer cases from Golestan, 2006-2016. Five-year age-standardized RS with their 95% confidence intervals (CIs) were calculated. The relationships between different variables with excess mortality rates were assessed by estimating adjusted excess hazard ratios (aEHRs) with their 95% CIs. RESULTS Overall, 718 cases of HNSCC and 386 thyroid cancer cases were enrolled. Five-year age-standardized RS (95% CI) were 36% (31-41) and 61% (52-69) in HNSCC and thyroid cancer patients, respectively. There were significant relationship between excess mortality rates in HNSCC patients with metastasis (aEHR= 3.31; 95%CI: 2.26-4.84), treatment type (4.19; 2.54-6.91, for no treatment as compared to receiving both surgery and chemoradiotherapy), age (2.16; 1.57-2.96, for older age group) and smoking (2.00; 1.45-2.75, for smokers as compared to non-smokers). Determinant of the excess mortality in thyroid cancer patients included metastasis (19.65; 8.08-47.79), tumor morphology (12.27; 4.62-32.58, for anaplastic cancer as compared to papillary cancer), treatment type (8.95, 4.13-19.4, for no treatment as compared to receiving both surgery and iodine therapy) and age (2.31; 1.17-4.54, for older age group). CONCLUSION Our findings suggested low RS for thyroid cancer in our population, while the estimates for HNSCC were comparable with other population. Metastasis, treatment type and age were determinants of mortality both in thyroid and HNSCC patients.
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Affiliation(s)
| | - Siamak Rajaei
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Golare Firouzei
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Mahdis Rajabalian
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohsen Mansoury
- Department of Statistics and Information Technology, Golestan University of Medical Sciences, Gorgan, Iran
| | - SeyedMehdi Sedaghat
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fahimeh Ghahraman
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fatemeh Ghasemi-Kebria
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.
| | - Elisabete Weiderpass
- Office of the Director, International Agency for Research on Cancer (IARC), Lyon, France
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran; Omid Cancer Research Center, Omid Preventive Medicine and Heath Promotion Center, Golestan University of Medical Sciences, Gorgan, Iran.
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7
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Kiong KL, Moreno A, Vu CN, Zheng G, Rosenthal DI, Weber RS, Lewis CM. Enhanced recovery after surgery (ERAS) in head and neck oncologic surgery: Impact on return to intended oncologic therapy (RIOT) and survival. Oral Oncol 2022; 130:105906. [PMID: 35594776 DOI: 10.1016/j.oraloncology.2022.105906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/09/2022] [Accepted: 05/07/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Enhanced Recovery After Surgery (ERAS) pathways in head and neck cancer (HNC) have shown to improve perioperative outcomes and reduce complications. The longer term implications on adjuvant treatment and survival have not been studied. We hereby report the first study on the impact of an ERAS pathway on return to intended oncologic treatment (RIOT) and overall survival (OS) in HNC. METHODS 200 patients undergoing head and neck oncologic surgery on an ERAS pathway between March 1, 2016 and March 31, 2019 were matched to controls over the same interval. Demographic, tumor and adjuvant therapy-related data were collected, including time to adjuvant therapy(TAT) and treatment package time(TPT). Risk factors for TAT > 42 days and TPT ≥ 85 days were assessed. OS was compared and risk factors for inferior OS determined. RESULTS Baseline characteristics including co-morbidities and tumor stage were similar. Of 179 patients planned for adjuvant treatment, there was no difference in RIOT rate (89.0% vs 87.5%, p = 0.753), proportion of TAT > 42 days of surgery (55.6% vs 59.7%, p = 0.642), or TPT ≥ 85 days (48.1% vs 57.1, p = 0.258), for the ERAS and control groups, respectively. On multivariate analysis, alcohol use (OR 3.58; 95 %CI 1.11-11.52) and recurrent disease status (OR 2.88; 95 %CI 1.40-5.93) were independently associated with prolonged TAT. Three-year OS was similar between the ERAS and control groups (73% vs 76%, p = 0.521). CONCLUSION ERAS has not shown to improve RIOT or OS in the current study. However, its benefit for perioperative outcomes is undeniable and further studies are required on longer term quality and survival outcomes.
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Affiliation(s)
- Kimberley L Kiong
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Amy Moreno
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Catherine N Vu
- Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Gang Zheng
- Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - David I Rosenthal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Randal S Weber
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Carol M Lewis
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
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Denissoff A, Huusko T, Ventelä S, Niemelä S, Routila J. Exposure to alcohol and overall survival in head and neck cancer: A regional cohort study. Head Neck 2022; 44:2109-2117. [PMID: 35713171 PMCID: PMC9545212 DOI: 10.1002/hed.27125] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/24/2022] [Accepted: 06/01/2022] [Indexed: 12/02/2022] Open
Abstract
Background There is a paucity of knowledge regarding the association of alcohol use with overall survival (OS) of patients with head and neck squamous cell carcinoma (HNSCC). Methods All 1033 patients treated for new HNSCC in Southwest Finland regional referral center of Turku University Hospital in 2005–2015. Cox regression analysis was used. Tumor TNM classification, age at baseline and tobacco smoking status were assessed as potential confounders. Results A history of severe harmful alcohol use with major somatic complications (HR: 1.41; 95%CI: 1.06–1.87; p = 0.017) as well as current use of at least 10 units per week (HR: 1.44, 95%CI: 1.16–1.78; p = 0.001) were associated with OS. Conclusions Alcohol consumption of 10–20 units/week, often regarded as moderate use, was found to increase risk of mortality independent of other prognostic variables. Systematic screening of risk level alcohol use and prognostic evaluation of alcohol brief intervention strategies is highly recommended.
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Affiliation(s)
- Alexander Denissoff
- Department of Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland.,Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Turku, Finland
| | - Teemu Huusko
- Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku, Turku, Finland.,Department for Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Turku, Finland
| | - Sami Ventelä
- Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku, Turku, Finland.,Department for Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Turku, Finland
| | - Solja Niemelä
- Department of Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland.,Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Turku, Finland
| | - Johannes Routila
- Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku, Turku, Finland.,Department for Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Turku, Finland
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Ingarfield K, McMahon AD, Hurley K, Toms S, Pring M, Thomas SJ, Waylen A, Pawlita M, Waterboer T, Ness AR, Conway DI. Inequality in survival of people with head and neck cancer: Head and Neck 5000 cohort study. Head Neck 2021; 43:1252-1270. [PMID: 33415733 DOI: 10.1002/hed.26589] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 11/30/2020] [Accepted: 12/17/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Explanations for socioeconomic inequalities in survival of head and neck cancer (HNC) patients have had limited attention and are not well understood. METHODS The UK Head and Neck 5000 prospective clinical cohort study was analyzed. Survival relating to measures of socioeconomic status was explored including area-based and individual factors. Three-year overall survival was determined using the Kaplan-Meier method. All-cause mortality was investigated via adjusted Cox Proportional Hazard models. RESULTS A total of 3440 people were included. Three-year overall survival was 76.3% (95% CI 74.9, 77.7). Inequality in survival by deprivation category, highest education level, and financial concerns was explained by age, sex, health, and behavioral factors. None of the potential explanatory factors fully explained the inequality associated with annual household income or the proportion of income of benefits. CONCLUSION These results support the interventions to address the financial issues within the wider care and support provided to HNC patients.
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Affiliation(s)
- Kate Ingarfield
- School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, UK.,Centre for Trials Research, College of Biomedical and Life Science, Cardiff University, Cardiff, UK.,National Institute for Health Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Alex D McMahon
- School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, UK
| | - Katrina Hurley
- National Institute for Health Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Stu Toms
- National Institute for Health Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Miranda Pring
- National Institute for Health Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Steve J Thomas
- National Institute for Health Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Andrea Waylen
- Bristol Dental School, University of Bristol, Bristol, UK
| | - Michael Pawlita
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andy R Ness
- National Institute for Health Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - David I Conway
- School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, UK
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10
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Five- and ten-year survival of squamous cell carcinoma of the head and neck in northern Thailand: a multivariate analysis. JOURNAL OF RADIOTHERAPY IN PRACTICE 2020. [DOI: 10.1017/s1460396920000540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AbstractAim:To report 5- and 10-year overall survival (OS) outcomes of squamous cell carcinoma of the head and neck and identify prognostic factors.Methods:Data on 2,095 patients at Maharaj Nakorn Chiang Mai Hospital, Thailand between 2007 and 2014 were analysed using the Kaplan–Meyer method to estimate 5- and 10-year OS rates. Cox proportional hazard regression models were applied to assess the independent prognostic factors of survival.Results:8·7% had hypopharyngeal cancer, 19·7% laryngeal, 53·3% oral cavity and 18·3% oropharyngeal. Two-thirds of the patients had locally advanced stage (III–IVB). Five- and ten-year OS rates were 30·1 and 22·8%, respectively.Conclusions:Cancer site, stage and age at diagnosis were associated with mortality, highlighting the importance of prevention and early detection.
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