Prognostic Factors in Head and Neck Cancer: A Retrospective Cohort Study of 3052 Patients in Brazil

Ana Letícia Mores; Carolina Guimarães Bonfim-Alves; Rossana Verónica Mendoza López; Leticia Rodrigues-Oliveira; Natália Rangel Palmier; Bruno Augusto Linhares Almeida Mariz; Cesar Augusto Migliorati; Luiz Paulo Kowalski; Alan Roger Santos-Silva; Thaís Bianca Brandão; Ana Carolina Prado-Ribeiro

doi:10.1111/odi.15196

Prognostic Factors in Head and Neck Cancer: A Retrospective Cohort Study of 3052 Patients in Brazil

Oral Dis. 2024 Dec 17. doi: 10.1111/odi.15196. Online ahead of print.

Authors

Affiliations

¹ Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
² Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo (ICESP-FMUSP), São Paulo, Brazil.
³ Center for Translational Oncology Research, Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo (ICESP-FMUSP), São Paulo, Brazil.
⁴ Dentistry Service, Vila Nova Star Hospital - Rede D'Or, São Paulo, Brazil.
⁵ Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, Florida, USA.
⁶ Department of Head and Neck Surgery, Faculty of Medicine, University of São Paulo (FMUSP), Head and Neck Surgery and Otorhinolaryngology Department, A.C.Camargo Cancer Center, Latin American Cooperative Oncology Group, São Paulo, Brazil.

PMID: 39688095
DOI: 10.1111/odi.15196

Abstract

Objective: Evaluate the sociodemographic, clinical, and lifestyle characteristics at head and neck squamous cell carcinoma (HNSCC) diagnosis and their impact on overall survival (OS) across different anatomical sites.

Materials and methods: A retrospective cohort study (2011-2021) at Instituto do Câncer do Estado de São Paulo, involving 3052 HNSCC patients. Survival analyses utilized the Kaplan-Meier method and Cox proportional hazard ratios with 95% confidence intervals, incorporating significant variables from univariate analysis.

Results: The five-year OS for all HNSCC sites (n = 3052) was 31.4%, with specific rates of 37.0% for laryngeal cancer (n = 935), 35.8% for oral cancer (n = 762), 26.6% for oropharyngeal cancer (OPC) (n = 1189), and 14.8% for hypopharyngeal cancer (n = 166). HPV-positive OPC had a higher five-year OS (59.3%; n = 127) compared to HPV-negative (35.4%; n = 226). Multivariable analysis identified older age (≥ 70 years) and advanced TNM stage (IV) as adverse prognostic factors for oral cavity, oropharynx, and larynx sites. Male gender was associated with poorer prognosis in the oral cavity, while alcohol consumption was linked to worse outcomes in oropharynx and larynx sites.

Conclusion: HNSCC OS remains low at a public cancer center in São Paulo. Older age, advanced tumor stage, and alcohol consumption are independent adverse prognostic factors, particularly in oropharynx and larynx sites.

Keywords: alcohol drinking; head and neck neoplasms; human papillomavirus; prognosis; survival; tobacco smoking.