Positive survival trend in metastatic head and neck cutaneous squamous cell carcinoma over four-decades: Multicenter study.


Journal

Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541

Informations de publication

Date de publication:
11 2019
Historique:
received: 22 02 2019
revised: 30 06 2019
accepted: 30 07 2019
pubmed: 14 8 2019
medline: 21 11 2020
entrez: 14 8 2019
Statut: ppublish

Résumé

This study assessed changes over time of survival of head and neck cutaneous squamous cell carcinoma (HNcSCC) with lymph node metastases. A multicenter analysis of 1301 patients with metastatic HNcSCC treated between 1980 and 2017. Differences in disease-specific survival (DSS) and overall survival (OS) by decade were assessed using multivariate Cox regression. Over the study period, we noted an increase in the proportion of patients aged over 80 years (3.9%-31.7%; P < .001) and immunosuppression (1.9%-9.9%; P = .03). After adjusting for number and size of metastatic nodes, extranodal extension, perineural invasion, immunosuppression, treatment, and institution, there was a reduction in risk of cancer-related mortality from 0.47 in 1990-1999 (P = .04) to 0.30 in 2000-2009 (P < .001) when compared to 1980-1989. This remained stable at 0.30 in 2010-2017 (P = .001). OS remained stable after 1990. Despite an aging and more frequently immunosuppressed population, fewer patients are dying from metastatic HNcSCC.

Sections du résumé

BACKGROUND
This study assessed changes over time of survival of head and neck cutaneous squamous cell carcinoma (HNcSCC) with lymph node metastases.
METHODS
A multicenter analysis of 1301 patients with metastatic HNcSCC treated between 1980 and 2017. Differences in disease-specific survival (DSS) and overall survival (OS) by decade were assessed using multivariate Cox regression.
RESULTS
Over the study period, we noted an increase in the proportion of patients aged over 80 years (3.9%-31.7%; P < .001) and immunosuppression (1.9%-9.9%; P = .03). After adjusting for number and size of metastatic nodes, extranodal extension, perineural invasion, immunosuppression, treatment, and institution, there was a reduction in risk of cancer-related mortality from 0.47 in 1990-1999 (P = .04) to 0.30 in 2000-2009 (P < .001) when compared to 1980-1989. This remained stable at 0.30 in 2010-2017 (P = .001). OS remained stable after 1990.
CONCLUSION
Despite an aging and more frequently immunosuppressed population, fewer patients are dying from metastatic HNcSCC.

Identifiants

pubmed: 31407466
doi: 10.1002/hed.25912
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

3826-3832

Informations de copyright

© 2019 Wiley Periodicals, Inc.

Références

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Auteurs

Shaheen Hasmat (S)

Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.
Western Sydney Clinical School, University of Sydney, Sydney, New South Wales, Australia.

Ardalan Ebrahimi (A)

Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.
Department of Head and Neck Surgery, Liverpool Hospital, Sydney, New South Wales, Australia.
Medical School, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia.

Peter P Luk (PP)

Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.
Western Sydney Clinical School, University of Sydney, Sydney, New South Wales, Australia.

Tsu-Hui Hubert Low (TH)

Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.
Central Clinical School, University of Sydney, Sydney, New South Wales, Australia.

Lachlan McDowell (L)

Department of Radiation Oncology, Peter McCollum Cancer Centre, Melbourne, Victoria, Australia.
Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia.

Matthew J R Magarey (MJR)

Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.

Michael Veness (M)

Department of Radiation Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales, Australia.

Ruta Gupta (R)

Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.
Central Clinical School, University of Sydney, Sydney, New South Wales, Australia.

Jonathan Clark (J)

Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.
Central Clinical School, University of Sydney, Sydney, New South Wales, Australia.

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