Presenting symptoms and long term survival in head and neck cancer

Douglas, C.M., Ingarfield, K., McMahon, A.D. , Savage, S.A., Conway, D.I. and MacKenzie, K. (2018) Presenting symptoms and long term survival in head and neck cancer. Clinical Otolaryngology, 43(3), pp. 795-804. (doi: 10.1111/coa.13053) (PMID:29247495)

Abstract

Objectives: To assess how type and number of symptoms are related to survival in patients with head and neck cancer. Design: Patients were followed up for over 10 years from the Scottish Audit of Head and Neck Cancer (national cohort of head and neck cancer patients in Scotland 1999-2001). September 2013, cohort was linked to national mortality data. First, second and third presenting symptoms were recorded at diagnosis. Setting: National prospective audit—Scotland. Participants: A subset of 1589 patients, from the original cohort of 1895, who had cancer arising from one of the four main subsites; larynx, oropharynx, oral cavity and hypopharynx. Main outcome measures: Median survival in relation to patients’ presenting symptoms. Results: A total of 1146 (72%) males and 443 (28%) females, mean age at diagnosis 64 years (13-95). There was a significant difference in survival in relation to the number of the patient's presenting symptoms; one symptom had a median survival of 5.3 years compared with 1.1 years for three symptoms. Patients who presented with weight loss had a median survival of 0.8 years, compared to 4.2 years if they did not (P < .001). Patients who presented with hoarseness had a median survival of 5.9 years compared to 2.6 years without (P < .001). There was no significant difference in long-term survival for patients who presented with an ulcer, compared to those that did not (P = .105). Conclusions: This study highlights the importance of patients’ presenting symptoms, giving valuable information in highlighting appropriate “red flag” symptoms and subsequent treatment planning and prognosis.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: MacKenzie, Mr Kenneth and Douglas, Miss Catriona and Ingarfield, Kate and Conway, Professor David and McMahon, Dr Alex
• Authors: Douglas, C.M., Ingarfield, K., McMahon, A.D., Savage, S.A., Conway, D.I., and MacKenzie, K.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
• Journal Name: Clinical Otolaryngology
• Publisher: Wiley
• ISSN: 1749-4478
• ISSN (Online): 1749-4486
• Published Online: 15 December 2017
• Copyright Holders: Copyright © 2017 John Wiley and Sons Ltd
• First Published: First published in Clinical Otolaryngology 43(3): 795-804
• Publisher Policy: Reproduced in accordance with the publisher copyright policy