Trends in disease-specific survival of head and neck squamous cell carcinoma patients treated in a single institution over a 30-year period

Abstract

Objective: Over the last few decades, there have been changes in the diagnostic capabilities and treatment of head and neck squamous cell carcinoma (HNSCC) patients. However, the impact of these changes on the ultimate survival of patients remains unclear. The objective of this study was to analyze the changes in disease-specific survival of patients with HNSCC treated consecutively over a period of 30 years in a tertiary center.

Material and methods: We carried out a retrospective analysis of 5,206 carcinomas located in the oral cavity, nasopharynx, oropharynx, hypopharynx, larynx or with metastatic squamous cell carcinoma without a known primary tumor treated in our center during the period 1985-2016. The overall and disease-specific survival was analyzed according to the year of diagnosis of the tumor.

Results: There was a significant trend towards an increase in disease-specific survival over the study period, with an average survival gain of 0.28% per year, which means an increase in 5-year disease-specific survival values from about 63.5% during the initial years of the study to 72% during the final years. Patients who had a greater increase in survival were those with primary tumors located in the rhino-oro-hypopharynx, with advanced tumors (stages III-IV) and treated with radiotherapy or chemoradiotherapy. This increase in disease-specific survival did not translate into overall survival.

Conclusion: Over the last 30 years we have observed a significant increase in the disease-specific survival of the patients with HNSCC, with an average increase of 0.28% per year in the 5-year specific-disease survival.

Keywords: Disease-specific survival; Epidemiology; Head and neck squamous cell carcinoma; Overall survival; Trend analysis.