scholarly journals The changing face of Irish head and neck cancer epidemiology: 20 years of data

2021 ◽  
Author(s):  
Gerard P. Sexton ◽  
Paul Walsh ◽  
Frank Moriarty ◽  
James Paul O’Neill
Keyword(s):  
Head And Neck Cancer ◽  
Oral Cavity ◽  
Head And Neck ◽  
Cancer Registry ◽  
Neck Cancer ◽  
Cancer Survival ◽  
Oral Cavity Cancer ◽  
The Elderly ◽  
Cancer Prevalence ◽  
Cancer Registry Data

Abstract Background Head and neck cancer (HNC) is associated with significant morbidity and mortality, especially when high stage disease is present. The epidemiology and prognosis of HNC has changed considerably over the last 20 years. Aims This study aimed to examine the epidemiological trends in HNC patients over a prolonged period in Ireland. Methods We conducted a retrospective cohort study using 20 years of cancer registry data provided by the National Cancer Registry of Ireland. Baseline characteristics and survival statistics were thereby generated. Results 10,148 patients were identified. There is a growing population of young (< 50 years) and very old (> 85 years) HNC patients; 48.15% of the population was elderly (> 65 years). Oral cavity (29.8%) and laryngeal cancer (28.1%) remain the most prevalent subsites, though oral cavity cancer prevalence declined from 35.9% in 1994 to 27.5% in 2014. Oropharyngeal cancer prevalence increased from 13.6 to 22.2% over the same period. Overall 5-year survival has improved significantly to 56.8% in 2010 but there remains a disparity between the elderly and adult cohorts (42.0% vs 60.7%). 5-year survival for hypopharyngeal and oropharyngeal cancers has improved from 11.8% and 33.3% to 22.2% and 44.8%, respectively, while laryngeal and oral cavity cancer survival remains approximately stable at 58.7% and 61.5%, respectively. Conclusion HNC survival in Ireland has improved in line with increasing recognition of the value of multidisciplinary assessment, subspecialisation in cancer care, and targeted therapies based on tumour subsites. Survival in the elderly cohort remains poor despite increasing recognition of the challenges such cases pose.

scholarly journals Age alone is not a barrier to concurrent chemoradiotherapy for advanced head and neck cancer

2021 ◽  
Author(s):  
Gerard Sexton ◽  
Paul Walsh ◽  
Frank Moriarty ◽  
James O'Neill
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Registry ◽  
Neck Cancer ◽  
Concurrent Chemoradiotherapy ◽  
Statistical Significance ◽  
Adult Population ◽  
Multivariate Regression Analysis ◽  
Cancer Registry Data ◽  
Significant Survival

Objectives To evaluate the benefits imparted by concurrent chemoradiotherapy (CCRT) and chemotherapy of any form to elderly head and neck cancer (HNC) patients in Ireland. Secondary outcomes included comparison of these benefits to the adult population and subgroup analysis by site. Design, setting, and participants A retrospective cohort study was conducted using 20 years of cancer registry data provided by the National Cancer Registry of Ireland. All HNC diagnosed from 1994-2014 were included. Cox multivariate regression analysis was applied to test for the benefits of CCRT and chemotherapy of any form in HNC. The primary outcome measures were cancer-specific and all-cause survival in months. Results Survival analysis showed an overall benefit to the use of CCRT in patients with advanced disease over 65 years, particularly when used for hypopharyngeal, oral cavity, oropharyngeal, and laryngeal malignancy, though the latter did not achieve statistical significance. Chemotherapy of any form conferred a survival benefit in elderly patients with hypopharyngeal, laryngeal, nasopharyngeal, and oropharyngeal cancer. Conclusion CCRT and chemotherapy of any form confer significant survival benefits to appropriately selected elderly HNC patients and should therefore not be withheld solely on the basis of age.

scholarly journals Submandibular gland flap in reconstruction of head and neck cancer defects

2020 ◽  
Vol 6 (12) ◽  
pp. 2267
Author(s):  
Viresh Arora ◽  
Bhushan Kathuria ◽  
Madhuri Arora
Keyword(s):  
Head And Neck Cancer ◽  
Oral Cavity ◽  
Head And Neck ◽  
Submandibular Gland ◽  
Neck Cancer ◽  
Oral Cavity Cancer ◽  
Wound Dehiscence ◽  
Free Flaps ◽  
Second Primary

<p class="abstract">Management of head and neck cancer defects has been challenging owing to the complexity of the created defects. Various local and regional flaps to free flaps have been described in the reconstruction of cancer defects, each of them having it’s own merits and limitations, therefore none of them appears as an ideal one. A Submandibular gland flap (SMGF) technique has emerged as a versatile flap having advantages of a regional and a free flap. In this study, eleven patients (four tongue, six buccal mucosa defects and one retromolar trigone defect) underwent reconstruction of oral cavity cancer defects with SMGF. The outcomes of the SMGF were evaluated in terms of the ease of harvest, functional outcome, and postoperative complications. The mean defect size and the flap dimensions were 4.4×3.9 cm and 3.6×3.3 cm respectively. One patient suffered wound infection resulting in partial flap necrosis with wound dehiscence. In the follow-up period one patient developed contra nodal recurrence and another patient developed a second primary on the contralateral base of the tongue. This study showed that SMGF is an excellent flap for the reconstruction of oral cavity cancer defects because of its reliability, versatility and its relative ease of application.</p>

scholarly journals Automating Treatment Summary Development Using Electronic Billing Information: A Pilot Study of Survivors of Head and Neck Cancer

2019 ◽  
Vol 15 (1) ◽  
pp. e84-e90
Author(s):  
Shrujal S. Baxi ◽  
Ranjit Sukhu ◽  
Elizabeth Fortier ◽  
Kevin Oeffinger ◽  
Stacie Corcoran ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Registry ◽  
Neck Cancer ◽  
Clinical Stage ◽  
Lymph Node Status ◽  
Billing Data ◽  
Cancer Registry Data ◽  
Using Data ◽  
Treatment Summary

PURPOSE: Although the provision of a treatment summary (TS) is a quality indicator in oncology, routine delivery of TSs remains challenging. Automatic TS generation could facilitate use, but data on accuracy are lacking in complex cancers such as head and neck cancer (HNC). We developed and evaluated an electronic platform to automate TS generation for HNC. METHODS: The algorithms autopopulated TSs using data from billing records and an institutional cancer registry. A nurse practitioner used the medical record to verify the accuracy of the information and made corrections electronically. Inaccurate and missing data were considered errors. We described and investigated reasons for errors in the automatically generated TSs. RESULTS: We enrolled a heterogeneous population of 43 survivors of HNC. Using billing data, the information on primary site, lymph node status, radiation, and chemotherapy use was accurate in 93%, 95%, 93%, and 95% of patients, respectively. Billing data captured surgery accurately in 77% of patients; once an omitted billing code was identified, accuracy increased to 98%. Chemotherapies were captured in 90% of patients. Using the cancer registry, month and year of diagnosis were accurate in 91% of cases; stage was accurate in 28% of cases. Reprogramming the algorithm to ascertain clinical stage when pathologic stage was unavailable resulted in 100% accuracy. The algorithms inconsistently identified radiation receipt and treating physicians from billing data. CONCLUSION: It is feasible to automatically and accurately generate most components of TSs for HNC using billing and cancer registry data, although clinical review is necessary in some cases.

scholarly journals Assessment of Tissue Autofluorescence and Reflectance for Oral Cavity Cancer Screening

2011 ◽  
Vol 145 (6) ◽  
pp. 956-960 ◽  
Author(s):  
Larissa Sweeny ◽  
Nichole R. Dean ◽  
J. Scott Magnuson ◽  
William R. Carroll ◽  
Lisa Clemons ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Oral Cavity ◽  
Head And Neck ◽  
Neck Cancer ◽  
White Light ◽  
Oral Cavity Cancer ◽  
Tertiary Care ◽  
Predictive Values ◽  
Published Evidence ◽  
Significant Difference

Objective. Although approved by the US Food and Drug Administration for clinical use, the utility of handheld tissue reflectance and autofluorescence devices for screening head and neck cancer patients is poorly defined. There is limited published evidence regarding the efficacy of these devices. The authors investigated the sensitivity and specificity of these modalities compared with standard examination. Study Design. Prospective, cross-sectional analysis. Setting. Tertiary care medical center. Subjects and Methods. Patients who were treated previously for head and neck cancer (n = 88) between 2009 and 2010 were included. Patients were screened using white light visualization (standard of care) and compared with tissue reflectance and autofluorescence visualization. Screening results were compared with biopsy or long-term follow-up. Results. Autofluorescence visualization had a specificity of 81% and a sensitivity of 50% for detecting oral cavity cancer, whereas white light visualization had a specificity of 98% and a sensitivity of 50%. Tissue reflectance visualization had low sensitivity (0%) and good specificity (86%). The power of this study was insufficient to compare the positive and negative predictive values of standard white light examination (50% and 98%, respectively) to tissue autofluorescence (11% and 97%) or reflectance (0% and 95%). In addition, stratification by previous radiation therapy found no statistically significant difference in screening results. Conclusion. Standard clinical lighting has a higher specificity than tissue reflectance and autofluorescence visualization for detection of disease in patients with a history of head and neck cancer. This study does not support the added costs associated with these devices.

Demographic predictors of head and neck cancer survival differ in the elderly

2018 ◽  
Vol 129 (1) ◽  
pp. 146-153 ◽  
Author(s):  
Sean T. Massa ◽  
Lauren M. Cass ◽  
Sai Challapalli ◽  
Zisansha Zahirsha ◽  
Matt Simpson ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Cancer Survival ◽  
The Elderly ◽  
Demographic Predictors

Improving the quality of multidisciplinary care for head and neck cancer.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 232-232 ◽  
Author(s):  
Carol M. Lewis ◽  
Zhannat Nurgalieva ◽  
Stephen Yenzen Lai ◽  
Randal S. Weber
Keyword(s):  
Head And Neck Cancer ◽  
Oral Cavity ◽  
Head And Neck ◽  
Laryngeal Cancer ◽  
Neck Cancer ◽  
Oropharyngeal Cancer ◽  
Treatment Guidelines ◽  
Oral Cavity Cancer ◽  
Nasopharyngeal Cancer

232 Background: As specialty- and disease-specific treatment recommendations based on the best available evidence and/or expert consensus, clinical practice guidelines such as those set forth by the National Comprehensive Care Network (NCCN) establish the current standard of quality care; adherence to these guidelines can serve as a measure of the quality and effectiveness of care. We aimed to assess multidisciplinary conference (MC) treatment recommendations’ adherence to NCCN head and neck cancer guidelines, while identifying potential areas for quality improvement. Methods: Patients presented with previously untreated head and neck cancers are being prospectively accrued as they are presented at weekly MC. The charts of patients presented between 10/20/2011 and 10/20/2013 were reviewed for clinical data leading up to MC to allow us to assess whether, based on the available information, the recommendations of conference are compliant with NCCN treatment guidelines. Results: Of 556 enrolled patients, 49.1% had oropharyngeal cancer, 28.2% had oral cavity cancer, 19.3% had laryngeal cancer, and 3.4% had nasopharyngeal cancer. For the entire cohort, the mean age at presentation was 58.9 years (16.4 - 89.3). Four hundred forty three patients (79.7%) were men. The recommendations of conference were non-compliant with NCCN treatment guidelines for 6.2% patients (17/273) with oropharyngeal cancer, 13.4% patients with oral cavity cancer (21/157), 0.9% patients (1/107) with laryngeal cancer, and 15.8% patients (3/19) with nasopharyngeal cancer. The most common reasons for non-compliance were recommended treatment of N2 oropharyngeal disease with definitive radiation alone (13 patients) and recommended over-use of induction chemotherapy (14 patients). Conclusions: NCCN guideline compliance can be used to evaluate the quality of head and neck cancer care. We have identified areas for potential improvement within our institution. Further study is needed to evaluate how care that deviates from NCCN guidelines affects patient outcomes.

scholarly journals Prevalência de Fadiga em Pacientes com Câncer de Cabeça e Pescoço Submetidos ao Tratamento de Radioquimioterapia: Revisão Sistemática

2021 ◽  
Vol 67 (3) ◽  
Author(s):  
Ana Carolina Lopes de Souza ◽  
Juliana Borges de Lima Dantas ◽  
Gabriela Botelho Martins ◽  
Ana Carla Barletta Sanches ◽  
Manoela Carrera ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Cancer Prevalence ◽  
Brief Fatigue Inventory

Introdução: A fadiga e considerada uma alteração reversível das funções biológicas, físicas e psíquicas, proveniente do desequilíbrio do organismo. Em pacientes com câncer, a fadiga e relatada como um dos sintomas mais frequentes, principalmente nos casos em que apresentam metástases, limitando de forma significativa as atividades diárias, sendo considerada como crônica. Objetivo: Avaliar a prevalência de fadiga em pacientes com câncer de cabeça e pescoço sob tratamento radioquimioterápico. Método: Foram instituídos a metodologia PRISMA e o anagrama PICO. Realizaram-se buscas nas bases de dados LILACS, PubMed, Google Academico e SciElo com os descritores “fatigue”; “cancer”; “prevalence”; “head and neck cancer”. Foram incluídos artigos científicos em inglês publicados entre 2009 a 2019. Cinco estudos avaliaram a ocorrência de fadiga isoladamente por meio do questionário Brief Fatigue Inventory (MBFI); e as variáveis coletadas por meio de entrevista utilizaram a Escala de Fadiga de Piper. Resultados: Do total de 243 pacientes, 70% apresentaram fadiga. Em outros 13 estudos, a fadiga foi avaliada em conjunto com outros sintomas por intermédio de questionários já validados na literatura. Houve aumento significativo nos escores de fadiga bem como nos sintomas relacionados a qualidade de vida a exemplo da dor, estresse e depressão nos 1908 pacientes entrevistados. Conclusão: A ocorrência de fadiga na população de pacientes com câncer de cabeça e pescoço foi alta e comumente esteve relacionada a outros sintomas como dor, distúrbios do sono, perda de apetite, dispneia, estresse emocional e depressão.

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