CC BY 4.0 · Indian J Med Paediatr Oncol 2022; 43(06): 500-506
DOI: 10.1055/s-0042-1758541
Original Article

Outcomes and Management of Head and Neck Cancer at a South Indian Cancer Centre: A Retrospective Study

Murugaiyan Nagarajan
1   Department of Oncology, Valavadi Narayanasamy Cancer Centre, G. Kuppuswamy Naidu Memorial Hospital, Coimbatore, Tamil Nadu, India
,
Ramesh Banu
1   Department of Oncology, Valavadi Narayanasamy Cancer Centre, G. Kuppuswamy Naidu Memorial Hospital, Coimbatore, Tamil Nadu, India
,
Ananthakrishnan Shrividhya
1   Department of Oncology, Valavadi Narayanasamy Cancer Centre, G. Kuppuswamy Naidu Memorial Hospital, Coimbatore, Tamil Nadu, India
,
Thirumalai Palanichamy Chellapandian
1   Department of Oncology, Valavadi Narayanasamy Cancer Centre, G. Kuppuswamy Naidu Memorial Hospital, Coimbatore, Tamil Nadu, India
,
Arumugham Rajkumar
1   Department of Oncology, Valavadi Narayanasamy Cancer Centre, G. Kuppuswamy Naidu Memorial Hospital, Coimbatore, Tamil Nadu, India
,
Ramaswamy Mohanraj
1   Department of Oncology, Valavadi Narayanasamy Cancer Centre, G. Kuppuswamy Naidu Memorial Hospital, Coimbatore, Tamil Nadu, India
› Author Affiliations
Funding None.

Abstract

Introduction Head and neck cancers are one of the most common cancers in the Indian subcontinent. The trends of these cancers worldwide have drastically changed over the past 15 years. In spite of all the new technology and timely diagnosis, the treatment of these cancers is still a challenge. These cancers still continue to be a significant cause of morbidity and mortality worldwide.

Objectives To identify different patterns of care received by patients with primary head and neck cancer in a single center and analyze the outcomes of the different patterns of care received by these patients in terms of overall survival and disease-free survival.

Materials and Methods We included 707 patients with primary head and neck cancer registered and treated in our institution from January 2015 to December 2017. The demographic details of the patient, treatment received, and outcomes of treatment were collected retrospectively from our hospital's medical registry. Descriptive analysis was performed by calculating mean and standard deviation for quantitative variables, whereas frequency and proportion were calculated for categorical variables. The mean/median overall survival and recurrence-free survival were compared across various explanatory parameters using log rank–test. A p-value < 0.05 was considered statistically significant.

Results A total of 707 patients were included in the final analysis. The median age of presentation was 60 years. In total, 50% of patients presented with stage IV disease at diagnosis and 78% had a history of smoking or other tobacco use. Oral cavity was the most common primary site. Concurrent chemotherapy with radiation therapy was the most common modality of treatment used in 49% of patients: RT was the common modality of treatment in 21% patients. Fourteen percent patients were treated by only surgery. All patients who underwent treatment were included for survival analysis, which showed that the median overall survival time was 42 months (34–49 months). The median duration of disease free-survival time was 37 months (30–43 months).

Conclusion In our study, most patients presented with locally advanced disease. Multimodality treatment yielded better results. Based on our study, in early-stage cancer, where single modality treatment was used, adjuvant therapy should be tailored based on nomogram.



Publication History

Article published online:
05 December 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68 (06) 394-424
  • 2 Rettig EM, D'Souza G. Epidemiology of head and neck cancer. Surg Oncol Clin N Am 2015; 24 (03) 379-396
  • 3 Johnson-Obaseki S, McDonald JT, Corsten M, Rourke R. Head and neck cancer in Canada: trends 1992 to 2007. Otolaryngol Head Neck Surg 2012; 147 (01) 74-78
  • 4 Rezende TMB, de Souza Freire M, Franco OL. Head and neck cancer: proteomic advances and biomarker achievements. Cancer 2010; 116 (21) 4914-4925
  • 5 Mehanna H, Paleri V, West CM, Nutting C. Head and neck cancer–Part 1: Epidemiology, presentation, and prevention. BMJ 2010; 341 (7774): c4684
  • 6 Wynder EL, Bross IJ, Feldman RM. A study of the etiological factors in cancer of the mouth. Cancer 1957; 10 (06) 1300-1323
  • 7 Franceschi S, Levi F, La Vecchia C. et al. Comparison of the effect of smoking and alcohol drinking between oral and pharyngeal cancer. Int J Cancer 1999; 83 (01) 1-4
  • 8 Francis D. Trends in the incidence of head and neck cancers in India. Eur J Cancer India 2018; 92 (01) S23
  • 9 Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol 2009; 45 (4-5): 309-316
  • 10 Guntinas-Lichius O, Wendt TG, Kornetzky N. et al. Trends in epidemiology and treatment and outcome for head and neck cancer: a population-based long-term analysis from 1996 to 2011 of the Thuringian cancer registry. Oral Oncol 2014; 50 (12) 1157-1164
  • 11 Roy S, Mandal TK, Das S. et al. Demography and pattern of care of patients with head-and-neck carcinoma: Experience from a tertiary care center in North India. Cancer Res Stat Treat 2020; 3: 730-735
  • 12 Das R, Kataki AC, Sharma JD, Baishya N, Kalita M, Krishnatreya M. A study of head and neck cancer patients with special reference to tobacco use and educational level. Clin Cancer Investig J 2017; 6 (01) 21
  • 13 Kulkarni MR. Head and neck cancer burden in India. Int J Head Neck Surg 2013; 4 (01) 29-35
  • 14 Steinbichler TB, Lichtenecker M, Anegg M. et al. Persistent head and neck cancer following first-line treatment. Cancers (Basel) 2018; 10 (11) 421
  • 15 Cadoni G, Giraldi L, Petrelli L. et al. Prognostic factors in head and neck cancer: a 10-year retrospective analysis in a single-institution in Italy. Acta Otorhinolaryngol Ital 2017; 37 (06) 458-466
  • 16 Novin K, Ameri A, Faraji S, Torbati P, Mortazavi N. Head and neck squamous cell carcinoma in Iran: Clinico-pathological and treatment-related factors influencing survival. Iran J Cancer Prev 2015; 8 (05) e3842
  • 17 Fouret P, Monceaux G, Temam S, Lacourreye L, St Guily JL. Human papillomavirus in head and neck squamous cell carcinomas in nonsmokers. Arch Otolaryngol Head Neck Surg 1997; 123 (05) 513-516
  • 18 Gillison ML, Koch WM, Capone RB. et al. Evidence for a causal association between human papillomavirus and a subset of head and neck cancers. J Natl Cancer Inst 2000; 92 (09) 709-720
  • 19 Mork J, Lie AK, Glattre E. et al. Human papillomavirus infection as a risk factor for squamous-cell carcinoma of the head and neck. N Engl J Med 2001; 344 (15) 1125-1131
  • 20 Blanchard P, Landais C, Lacas B, Petit C, Bourhis J, Pignon JP. SP-010: update of the meta-analysis of chemotherapy in head and neck cancer (MACH-NC). Radiother Oncol 2017; 1 (122) 9
  • 21 Roy S, Mallik C, Ghorai S, Hazra A, Majumdar A. Hypofractionated versus conventional radiotherapy with or without chemotherapy in head and neck cancer: a comparative study. Clin Cancer Investig J 2015; 4: 140-146
  • 22 Beitler JJ, Zhang Q, Fu KK. et al. Final results of local-regional control and late toxicity of RTOG 9003: a randomized trial of altered fractionation radiation for locally advanced head and neck cancer. Int J Radiat Oncol Biol Phys 2014; 89 (01) 13-20
  • 23 Trotti III A, Zhang Q, Bentzen SM. et al. Randomized trial of hyperfractionation versus conventional fractionation in T2 squamous cell carcinoma of the vocal cord (RTOG 9512). Int J Radiat Oncol Biol Phys 2014; 89 (05) 958-963