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. 2020 Mar:6:486-499.
doi: 10.1200/GO.20.00014.

Predictors of Survival After Head and Neck Squamous Cell Carcinoma in South America: The InterCHANGE Study

Renata Abrahão  1   2 , Sandra Perdomo  1   3   4 , Luis Felipe Ribeiro Pinto  5 , Flávia Nascimento de Carvalho  5 , Fernando Luis Dias  5 , José Roberto V de Podestá  6 , Sandra Ventorin von Zeidler  7 , Priscila Marinho de Abreu  7 , Marta Vilensky  8 , Raul Eduardo Giglio  8 , José Carlos Oliveira  9 , Matinair Siqueira Mineiro  9 , Luiz P Kowalski  10 , Mauro K Ikeda  10 , Mauricio Cuello  11 , Andres Munyo  11 , Paula A Rodríguez-Urrego  4 , José Antonio Hakim  4 , David Alfonso Suarez-Zamora  4 , Federico Cayol  12 , Marcelo Fernando Figari  12 , Javier Oliver  12 , Valerie Gaborieau  1 , Ruth H Keogh  13 , Paul Brennan  1 , Maria Paula Curado  10 ; InterCHANGE Group
Affiliations

Predictors of Survival After Head and Neck Squamous Cell Carcinoma in South America: The InterCHANGE Study

Renata Abrahão et al. JCO Glob Oncol. 2020 Mar.

Abstract

Purpose: Head and neck squamous cell carcinoma (HNSCC) incidence is high in South America, where recent data on survival are sparse. We investigated the main predictors of HNSCC survival in Brazil, Argentina, Uruguay, and Colombia.

Methods: Sociodemographic and lifestyle information was obtained from standardized interviews, and clinicopathologic data were extracted from medical records and pathologic reports. The Kaplan-Meier method and Cox regression were used for statistical analyses.

Results: Of 1,463 patients, 378 had a larynx cancer (LC), 78 hypopharynx cancer (HC), 599 oral cavity cancer (OC), and 408 oropharynx cancer (OPC). Most patients (55.5%) were diagnosed with stage IV disease, ranging from 47.6% for LC to 70.8% for OPC. Three-year survival rates were 56.0% for LC, 54.7% for OC, 48.0% for OPC, and 37.8% for HC. In multivariable models, patients with stage IV disease had approximately 7.6 (LC/HC), 11.7 (OC), and 3.5 (OPC) times higher mortality than patients with stage I disease. Current and former drinkers with LC or HC had approximately 2 times higher mortality than never-drinkers. In addition, older age at diagnosis was independently associated with worse survival for all sites. In a subset analysis of 198 patients with OPC with available human papillomavirus (HPV) type 16 data, those with HPV-unrelated OPC had a significantly worse 3-year survival compared with those with HPV-related OPC (44.6% v 75.6%, respectively), corresponding to a 3.4 times higher mortality.

Conclusion: Late stage at diagnosis was the strongest predictor of lower HNSCC survival. Early cancer detection and reduction of harmful alcohol use are fundamental to decrease the high burden of HNSCC in South America.

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Conflict of interest statement

Sandra Perdomo

Consulting or Advisory Role: Bristol-Myers Squibb

Raul Eduardo Giglio

Consulting or Advisory Role: MSD

Speakers' Bureau: MSD, Biotoscana, Merck KGaA, Bristol-Myers Squibb

Travel, Accommodations, Expenses: MSD, Bristol-Myers Squibb

José Antonio Hakim

Honoraria: Johnson & Johnson

Federico Cayol

Research Funding: Merck KGaA

Travel, Accommodations, Expenses: Roche, MSD Oncology, Merck KGaA

No other potential conflicts of interest were reported.

Figures

FIG 1
FIG 1
Overall survival by stage at diagnosis of head and neck squamous cell carcinoma for each anatomic site in the InterCHANGE study (2011-2017).
FIG 2
FIG 2
Three-year overall survival (and 95% CI) from oropharynx cancer by human papillomavirus (HPV) type 16 status in the InterCHANGE study (2011-2017).
See this image and copyright information in PMC

References

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