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. 2017 Nov 1;28(11):2843-2851.
doi: 10.1093/annonc/mdx486.

Alcohol and cigarette consumption predict mortality in patients with head and neck cancer: a pooled analysis within the International Head and Neck Cancer Epidemiology (INHANCE) Consortium

L Giraldi  1 , E Leoncini  1 , R Pastorino  2 , V Wünsch-Filho  3 , M de Carvalho  4 , R Lopez  5 , G Cadoni  6 , D Arzani  1 , L Petrelli  6 , K Matsuo  7 , C Bosetti  8 , C La Vecchia  9 , W Garavello  10 , J Polesel  11 , D Serraino  11 , L Simonato  12 , C Canova  13 , L Richiardi  14 , P Boffetta  15 , M Hashibe  16 , Y C A Lee  17 , S Boccia  18
Affiliations

Alcohol and cigarette consumption predict mortality in patients with head and neck cancer: a pooled analysis within the International Head and Neck Cancer Epidemiology (INHANCE) Consortium

L Giraldi et al. Ann Oncol. .

Abstract

Background: This study evaluated whether demographics, pre-diagnosis lifestyle habits and clinical data are associated with the overall survival (OS) and head and neck cancer (HNC)-specific survival in patients with HNC.

Patients and methods: We conducted a pooled analysis, including 4759 HNC patients from five studies within the International Head and Neck Cancer Epidemiology (INHANCE) Consortium. Cox proportional hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) were estimated including terms reported significantly associated with the survival in the univariate analysis.

Results: Five-year OS was 51.4% for all HNC sites combined: 50.3% for oral cavity, 41.1% for oropharynx, 35.0% for hypopharynx and 63.9% for larynx. When we considered HNC-specific survival, 5-year survival rates were 57.4% for all HNC combined: 54.6% for oral cavity, 45.4% for oropharynx, 37.1% for hypopharynx and 72.3% for larynx. Older ages at diagnosis and advanced tumour staging were unfavourable predictors of OS and HNC-specific survival. In laryngeal cancer, low educational level was an unfavourable prognostic factor for OS (HR = 2.54, 95% CI 1.01-6.38, for high school or lower versus college graduate), and status and intensity of alcohol drinking were prognostic factors both of the OS (current drinkers HR = 1.73, 95% CI 1.16-2.58) and HNC-specific survival (current drinkers HR = 2.11, 95% CI 1.22-3.66). In oropharyngeal cancer, smoking status was an independent prognostic factors for OS. Smoking intensity (>20 cigarettes/day HR = 1.41, 95% CI 1.03-1.92) was also an independent prognostic factor for OS in patients with cancer of the oral cavity.

Conclusions: OS and HNC-specific survival differ among HNC sites. Pre-diagnosis cigarette smoking is a prognostic factor of the OS for patients with cancer of the oral cavity and oropharynx, whereas pre-diagnosis alcohol drinking is a prognostic factor of OS and HNC-specific survival for patients with cancer of the larynx. Low educational level is an unfavourable prognostic factor for OS in laryngeal cancer patients.

Keywords: epidemiology; head and neck cancer; pooled analysis; prognostic factors.

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Figures

Figure 1.
Figure 1.
Kaplan–Meier unadjusted overall 5-year survival by head and neck cancer site.
Figure 2.
Figure 2.
Kaplan–Meier unadjusted specific 5-year survival by head and neck cancer site.
See this image and copyright information in PMC

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