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. 2022 Nov-Dec;88 Suppl 4(Suppl 4):S124-S132.
doi: 10.1016/j.bjorl.2022.07.003. Epub 2022 Aug 5.

Prognostic factors in oropharyngeal squamous cell carcinoma in the state of São Paulo, Brazil: 10-year follow-up

Fabio Lau  1 , Jonas Belchior Tamanini  2 , Fabio Portella Gazmenga  2 , Gustavo Mercuri  2 , Vanessa Carvalho de Oliveira  2 , Daniel Naves Araújo Teixeira  2 , Eduardo Vieira Couto  2 , Carlos Takahiro Chone  2
Affiliations

Prognostic factors in oropharyngeal squamous cell carcinoma in the state of São Paulo, Brazil: 10-year follow-up

Fabio Lau et al. Braz J Otorhinolaryngol. 2022 Nov-Dec.

Abstract

Objective: To descriptively analyze the epidemiological data, clinical stage, and outcomes of oropharyngeal squamous cell carcinoma in the state of São Paulo, Brazil, and to estimate the influence of clinical stage and treatment type on overall and disease-free survival.

Methods: We retrospectively analyzed epidemiological data from the São Paulo Cancer Center Foundation database relative to patients with oropharyngeal squamous cell carcinoma diagnosed between 2004 and 2014 in the state of São Paulo. Univariate and multivariate Cox regression analyses were performed to assess factors associated with the outcomes. A forward stepwise selection procedure was used. Survival curves were estimated by the Kaplan-Meier method and compared by the Gehan-Breslow-Wilcoxon test.

Results: A total of 8075 individuals with oropharyngeal squamous cell carcinoma were identified. Of these, 86.3% were diagnosed at an advanced stage and 13.7% at an early stage. Only 27.2% of patients were treated surgically, whereas 57.5% were treated medically. Patients undergoing surgery had longer overall survival than those receiving medical treatment in both early- and advanced-stage oropharyngeal squamous cell carcinoma. However, there was no significant difference in disease-free survival between surgical and medical treatment.

Conclusion: No significant difference in disease-free survival between medical and surgical treatment suggests similar complete remission rates with both approaches. Patients receiving medical treatment had shorter overall survival, which may be due to complications from chemotherapy and radiotherapy. However, we cannot confirm this relationship based on the data provided by the São Paulo Cancer Center Foundation. Prospective studies are warranted to assess whether the lower overall survival rate in patients receiving medical treatment is secondary to complications from chemotherapy and radiotherapy.

Level of evidence: 2C.

Keywords: Oropharynx; Squamous cell carcinoma; Survival.

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Figures

Figure 1
Figure 1
Incidence of oropharyngeal squamous cell carcinoma in the state of São Paulo, Brazil, 2004‒2014.
Figure 2
Figure 2
Kaplan-Meier curve of overall survival (all-cause mortality) for patients with oropharyngeal squamous cell carcinoma in the state of Sao Paulo, Brazil, 2004‒2014. Cumulative survival (standard error): 1-year: 60.6% (0.5%); 5-years: 23.7% (0.5%); 10 years: 13.4% (0.6%).
Figure 3
Figure 3
Kaplan-Meier curve of disease-free survival (all-cause mortality) for patients with oropharyngeal squamous cell carcinoma in the state of São Paulo, Brazil, 2004‒2014. Cumulative survival (standard error): 1-year: 91.1% (0.4%); 5-years: 67.7% (0.8%); 10-years: 59.0% (1.3%).
Figure 4
Figure 4
Kaplan-Meier curve of death according to clinical stage and treatment for patients with oropharyngeal squamous cell carcinoma in the state of São Paulo, Brazil, 2004‒2014.
Figure 5
Figure 5
Kaplan-Meier curve of disease-free survival according to clinical stage and treatment for patients with oropharyngeal squamous cell carcinoma in the state of São Paulo, Brazil, 2004‒2014.
See this image and copyright information in PMC

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