The influence of smoking, age and stage at diagnosis on the survival after larynx, hypopharynx and oral cavity cancers in Europe: the ARCAGE study

Abrahão, R. et al. (2018) The influence of smoking, age and stage at diagnosis on the survival after larynx, hypopharynx and oral cavity cancers in Europe: the ARCAGE study. International Journal of Cancer, 143(1), pp. 32-44. (doi: 10.1002/ijc.31294) (PMID:29405297)

Abstract

Head and neck cancer (HNC) is a preventable malignancy that continues to cause substantial morbidity and mortality worldwide. Using data from the ARCAGE and Rome studies, we investigated the main predictors of survival after larynx, hypopharynx and oral cavity (OC) cancers. We used the Kaplan-Meier method to estimate overall survival, and Cox proportional models to examine the relationship between survival and sociodemographic and clinical characteristics. 604 larynx, 146 hypopharynx and 460 OC cancer cases were included in this study. Over a median follow-up time of 4.6 years, nearly 50% (n=586) of patients died. Five-year survival was 65% for larynx, 55% for OC, and 35% for hypopharynx cancers. In a multivariable analysis, we observed an increased mortality risk among older (≥71 years) vs. younger (≤50 years) patients with larynx/hypopharynx combined (LH) and OC cancers [HR=1.61, 95% CI 1.09–2.38 (LH) and HR=2.12, 95% CI 1.35–3.33 (OC)], current vs. never smokers [HR=2.67, 95% CI 1.40–5.08 (LH) and HR=2.16, 95% CI 1.32–3.54 (OC)], and advanced vs. early stage disease at diagnosis [IV vs. I, HR=2.60, 95% CI 1.78–3.79 (LH) and HR=3.17, 95% CI 2.05–4.89 (OC)]. Survival was not associated with sex, alcohol consumption, education, oral health, p16 expression, presence of HPV infection, or body mass index 2 years before cancer diagnosis. Despite advances in diagnosis and therapeutic modalities, survival after HNC remains low in Europe. In addition to the recognized prognostic effect of stage at diagnosis, smoking history and older age at diagnosis are important prognostic indicators for HNC.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Wright, Dr Sylvia and Conway, Professor David
• Authors: Abrahão, R., Anantharaman, D., Gaborieau, V., Abedi-Ardekani, B., Lagiou, P., Lagiou, A., Ahrens, W., Holcatova, I., Betka, J., Merletti, F., Richiardi, L., Kjaerheim, K., Serraino, D., Polesel, J., Simonato, L., Alemany, L., Agudo Trigueros, A., Macfarlane, T. V., Macfarlane, G. J., Znaor, A., Robinson, M., Canova, C., Conway, D. I., Wright, S., Healy, C. M., Toner, M., Cadoni, G., Boccia, S., Gheit, T., Tommasino, M., Scelo, G., and Brennan, P.
• College/School: College of Medical Veterinary and Life Sciences > School of Cancer Sciences; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
• Journal Name: International Journal of Cancer
• Publisher: Wiley
• ISSN: 0020-7136
• ISSN (Online): 1097-0215
• Published Online: 06 February 2018
• Copyright Holders: Copyright © 2018 UICC
• First Published: First published in International Journal of Cancer 143(1):32-44
• Publisher Policy: Reproduced in accordance with the publisher copyright policy