TITLE:
Competing Causes of Death in 138 Patients with Loco-Regionally Advanced Head and Neck Cancer Treated with Multi-Modality Treatment
AUTHORS:
D. Dequanter, M. Shahla, C. Aubert, Y. Deniz, P. Lothaire
KEYWORDS:
Mortality in Treated Head and Neck Patients, Advanced Head and Neck Disease, Surgical Resection, (Chemo) Radiotherapy
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.6 No.5,
May
18,
2015
ABSTRACT: Introduction: The goal of this study
was to analyze the causes of death in patients with loco-regionally advanced
squamous cell carcinoma (HNSCC) of the head and neck treated with multimodality
treatment. Materiel: The mortality records of 138 advanced head and neck
patients treated in our department with surgery and adjuvant (chemo)
radiotherapy from 2007 to 2013 were collected and reviewed in this study.Results: From May 2007 to January
2013, 138 patients were followed up with a median follow-up duration of 25
months. The 5-year overall survival (OS), disease-free survival (DFS) were 45%,
and 56.1%, respectively. A total of 39 patients (28%) died during the follow-up
period. Clearly, in this population, loco-regional relapse accounted for one of
the most cause of death but acute and late or chronic treatment-associated
causes leading to death occurred in almost 8% of the patients. Furthermore, the
risk of death from head and neck squamous cell carcinoma (HNSCC) was greater in
patients with hypopharynx cancer. Univariate analysis indicated that patients
with N2b disease and above and vascular tumor embolism had a lower overall
survival (p = 0.001 and p = 0.007 respectively). The multivariate analysis
showed that N2b disease and above was an independent prognostic factor for
poorer loco-regional control (p = 0.001). Conclusions: Patients with locally
advanced head and neck cancer treated with surgery and adjuvant (chemo)
radiotherapy are potentially curable but face significant risks of mortality
from causes other than disease progression.