Patterns of head and neck cancer incidence, mortality, and survival in the U.S. Hispanic population.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e13084-e13084
Author(s):  
Melissa S. Oh ◽  
Renjian Jiang ◽  
Yuan Liu ◽  
Xiting Zhu ◽  
Nabil F. Saba ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Oral Cavity ◽  
Head And Neck ◽  
Neck Cancer ◽  
Hispanic Population ◽  
Annual Percent Change ◽  
Kaplan Meier ◽  
Incidence And Mortality ◽  
Ethnic Subgroups ◽  
The U.S

e13084 Background: To compare the incidence, mortality, and survival of head and neck cancer (HNCA) in the U.S. Hispanic population to other racial/ethnic groups. Methods: Using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program, we compared the incidence and mortality of cancer of the oral cavity, pharynx, and larynx between the U.S. Hispanic population versus other racial and ethnic subgroups, as well as the annual percent change between 2000-2013. A comparative analysis for different groups stratified by age and sex was performed. Survival analysis was performed using Kaplan-Meier estimate and logistic regression analysis. Results: The incidence of oral cavity, pharyngeal, and laryngeal cancers were significantly lower in Hispanics compared to Non-Hispanics (p < 0.05). The incidence of laryngeal cancer decreased significantly at a rate of 2.5% annually (p < 0.05), while incidence of oral cavity and pharyngeal cancers remained unchanged in U.S. Hispanics. The mortality rate for oral cavity, pharyngeal, and laryngeal cancers in the U.S. Hispanic population were 1.4 per 100,000, 1.1 per 100,000, and 1.2 per 100,000 respectively. Mortality rates in Hispanics were significantly lower compared to Non-Hispanics (p < 0.05). Non-Hispanics Blacks had the highest HNCA-related mortality among all the compared groups. The mortality of HNCA was significantly declining annually in the U.S. Hispanic population (p < 0.05). Conclusions: The incidence and mortality of HNCA in the U.S. Hispanic population appears to be declining and is significantly lower compared to Non-Hispanics.

Quality Indicators: Measurement and Predictors in Head and Neck Cancer Free Flap Patients

2018 ◽  
Vol 158 (2) ◽  
pp. 265-272 ◽  
Author(s):  
Antoine Eskander ◽  
Stephen Y. Kang ◽  
Benjamin Tweel ◽  
Jigar Sitapara ◽  
Matthew Old ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Length Of Stay ◽  
Oral Cavity ◽  
Head And Neck ◽  
Neck Cancer ◽  
Free Flap ◽  
Preoperative Assessment ◽  
Assessment Clinic ◽  
Primary Radiotherapy ◽  
The Impact

Objective To determine the predictors of length of stay (LOS), readmission within 30 days, and unplanned return to the operating room (OR) within 30 days in head and neck free flap patients. Study Design Case series with chart review. Setting Tertiary academic cancer hospital. Subjects and Methods All head and neck free flap patients at The Ohio State University (OSU, 2006-2012) were assessed. Multivariable logistic regression to assess the impact of patient factors, flap and wound factors, and intraoperative factors on the aforementioned quality metric outcomes. Results In total, 515 patients were identified, of whom 66% had oral cavity cancers, 33% had recurrent tumors, and 28% underwent primary radiotherapy. Of the patients, 31.5% had a LOS greater than 9 days, predicted by longer operative time, oral cavity and pharyngeal tumor sites, blood transfusion, diabetes mellitus, and any complication. A total of 12.6% of patients were readmitted within 30 days predicted by absent OSU preoperative assessment clinic attendance and any complication, and 14.8% of patients had an unplanned OR return predicted by advanced age. Conclusions When assessing quality metrics, adjustment for the complexity involved in managing patients with head and neck cancer with a high comorbidity index, clean contaminated wounds, and a high degree of primary radiotherapy is important. Patients seen in a preoperative assessment clinic had a lower risk of readmission postoperatively, and this should be recommended for all head and neck free flap patients. Quality improvement projects should focus on predictors and prevention of complications as this was the number one predictor of both increased length of stay and readmission.

Gustatory disturbances occur in patients with head and neck cancer who undergo radiotherapy not directed to the oral cavity

Oral Oncology ◽  
2019 ◽  
Vol 95 ◽  
pp. 115-119 ◽  
Author(s):  
José Lucas Barbosa da Silva ◽  
Richard L. Doty ◽  
João Victor Massamitsu Katayama Miyazaki ◽  
Ricardo Borges ◽  
Fábio de Rezende Pinna ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Oral Cavity ◽  
Head And Neck ◽  
Neck Cancer

Analysis of risk factors for oral cavity and oropharynx cancer in the authors’ own material

2017 ◽  
Vol 71 (2) ◽  
pp. 23-28 ◽  
Author(s):  
Joanna Nowosielska-Grygiel ◽  
Kalina Owczarek ◽  
Marzena Bielińska ◽  
Magdalena Wacławek ◽  
Jurek Olszewski
Keyword(s):  
Risk Factors ◽  
Head And Neck Cancer ◽  
Oral Cavity ◽  
Head And Neck ◽  
Neck Cancer ◽  
Sexual Partners ◽  
Oral Sex ◽  
Cancer Awareness ◽  
Oropharynx Cancer ◽  
Hoarse Voice

Introduction: The aim of the study was to analyse the risk factors for oral cavity and oropharynx cancer in peopled examined under the Head and Neck Cancer Awareness Week in 2016, Lodz. Material and methods. In Lodz, 21st September 2016, under the Head and Neck Cancer Awareness Week, 106 people, including 67 women aged 29–77 and 39 men aged 23–84, underwent preventive examinations in the hospital department. Prior to the laryngological examination, the patients were asked to answer questions that referred to their education, medical case history, symptoms, smoking habits with the number of cigarettes per day, alcohol intake, the number of lifetime sexual partners, oral sex engagement, incidents of head and neck cancer in the family history. Results: The major part of the examined patients were women and men with the secondary and high level of education, 47,76% and 35,82%, and 58,97% and 35,91% respectively. The patients were informed by mass media about the planned preventive medical examinations – 80,60% women and 79,49% men. The most common symptoms reported by women were: hoarse voice in 61,19% cases, dysphagia in 32,84% cases and burning sensation and/or pain in the oral cavity in 29,85% cases. The examined male patients mainly showed hoarse voice (46,15%), other symptoms (43,59%) and dysphagia (25,64%). 28,35% women and 28,20% men smoked cigarettes, while passive smokers were 22,38% and 25,64% respectively. Alcohol consumption was reported by 67,16% women and 82,05% men, rather occasionally. Having oral sex was noted in 25,37% women and 38,46% men, mostly with multiple sexual partners. Among the studied patients, 13,43% women and 5,12% men suffered from malignant cancer, including 2,98% women and 2,56% men who reported head and neck carcinoma in the medical interview. On the basis of the interview and ENT examination, 11,94% women and 17,94% men were qualified for the extended oncological diagnostics. Conclussion. The Fourth Head and Neck Cancer Awareness Week shows the increased interest in preventive screening, especially oncological screening, and thus the necessity of such preventive activities in the future.

Health related quality of life (HRQoL) and demographic characteristics of long term head and neck cancer survivors submitted to concomitant chemoradiation in Brazil

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18572-18572
Author(s):  
D. V. Santos ◽  
K. M. Kiyota ◽  
I. Snitcovsky ◽  
G. M. Leitão ◽  
M. H. Federico
Keyword(s):  
Head And Neck Cancer ◽  
Oral Cavity ◽  
Head And Neck ◽  
Neck Cancer ◽  
Financial Distress ◽  
Mouth Opening ◽  
Demographic Characteristics ◽  
Emotional Function ◽  
Related Quality ◽  
Eortc Qlq

18572 Background: Head and neck cancer (HNC) is a stigmatizing disease. In order to identify special needs in these patients (pts), we evaluated HRQoL and the demographic characteristics of HNC pts who had survived at least one year after chemoradiation. Methods: Our survey, done in may 2005, identified 42 pts alive (from 527 admitted from May 2002 to May 2004 treated with either exclusive (n = 19) or adjuvant (n = 23) chemoradiation. These pts as well 16 normal controls, were interviewed and invited to complete EORTC-QLQ-C30 and HN35. These questionnaires had already been validated for Brazilian Portuguese. Primary site was 12 oral cavity, 14 pharynx, 13 larynx, 3 not determined. Age 60.3 ± 9.0 y, 36 male and 6 female; 39 were squamous cell carcinoma and 3 other type; 28 were stage III or IV; 40 had no evidence of disease and two had recurrent disease at the time of survey. Comparison between groups were done by using the Mann-Whitney test and differences of at least 10 points was considered of clinical significance. Simple correlations were conducted between HRQoL variables and clinical correlates and demographics. The level of significance was established at p < 0.05. This work was conducted according to Helsinki declaration and Brazilian law. Results: Scores relative to global QoL (p = 0.18) and emotional function (p = 0.59) did not differ in pts as compared to controls. Pts presented worse scores in swallowing, senses, speech, pain, dental problems, xerostomia and mouth opening (all p < 0.05). Emotional function (r = 0.316, p = 0.041) and financial worries (r = −0.509, p = 0.001) impacted on global QoL, what did not happen with marital status, income and level of education, age or previous surgery. Chronic pain was more prevalent in oral cavity tumors than in other sites such as pharynx or larynx tumors (p = 0.046 and p = 0.030, respectively). Pts with larynx tumors presented worse cough score as compared to those with pharynx tumors (p = 0.009). Conclusions: Providing continuous oral and dental care seems to be important to address survivors’ concerns. Financial distress could be ameliorated by a better social support system. Tumor site seem to affect differently some domains of HRQoL, in contrast to organ preservation. No significant financial relationships to disclose.

Beyond race: The impact of ethnicity on the treatment outcome of locally advanced head and neck cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 16500-16500
Author(s):  
C. J. Calfa ◽  
M. Escalon ◽  
S. Zafar ◽  
E. Lopez ◽  
V. Patel ◽  
...  
Keyword(s):  
Overall Survival ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Statistical Significance ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Advanced Head ◽  
Kaplan Meier ◽  
The Impact

16500 Background: Self identified racial groups share an unequal burden of head and neck cancer . Recent evidence suggests that outcome among races is different and the causes are multifactorial. Nonetheless, differences among ethnic groups have not been reported. Herein, we decided to analyze differences in treatment response and outcome among our white and Hispanic patient population treated for locally advanced head and neck cancer. Methods: Patients were identified using the tumor registry. We reviewed retrospectively the data from medical records. 100 white Hispanics (WH) and 50 white non-Hispanics (WNH) diagnosed with locally advanced head and neck cancer and treated at our institution from 2004 to 2005, were eligible for the study. Standard statistical analysis, including Kaplan-Meier survival curve and Cox proportional hazard models were used. P value of <0.05 was considered for statistical significance. Results: Preliminary results reveal that, in our study population, median age at diagnosis, gender, performance status (ECOG 0–2) and squamous cell histology did not differ significantly between the two groups. Stage 4 at diagnosis was more commonly observed in Hispanics as opposed to WNH (85.7% vs 68.6%) (P = 0.1). Surgery was more commonly used as an initial treatment option in Hispanics than WNH (42.8% vs 28.6%) (P = 0.18) while chemotherapy was less likely to be used (78.6% vs. 91.4%) (P = 0.15). Hispanics were more likely to smoke than WNH (P = 0.0003) and were equally exposed to chronic alcohol use. Patients from the Hispanic group were more likely to respond to therapy than whites by Chi-squared analysis but this difference was not statistically significant (P = 0.09). No differences were seen in disease free survival. Kaplan-Meier estimate of median overall survival was 16 months for Hispanics vs. 25 months for whites but this difference did not reach statistical significance (P = 0.26). Final analysis will be available at the time of the annual meeting. Conclusion: In our experience, a trend for decrease overall survival was noted in the Hispanic ethnic group. This may be in part due to more advanced stage at presentation. Nonetheless, in order to definitively answer this question, further research is warranted. No significant financial relationships to disclose.

Promoter hypermethylation of GPX3 as a predictor for chemoresistance and survival in head and neck cancer patients

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6027-6027 ◽  
Author(s):  
Z. Guo ◽  
Z. Chen ◽  
Z. Yang ◽  
L. Schumaker ◽  
K. J. Cullen
Keyword(s):  
Head And Neck Cancer ◽  
Survival Analysis ◽  
Relative Risk ◽  
Head And Neck ◽  
Cancer Cells ◽  
Cell Lines ◽  
Neck Cancer ◽  
Promoter Hypermethylation ◽  
Exact Test ◽  
Kaplan Meier

6027 Background: Resistance of cancer cells to cisplatin and its analogues is the major limitation in clinical application of cisplatin-based chemotherapy. The mechanisms by which cancer cells develop resistance to the drugs are still unclear, and there is no way currently to predict the drug resistance of individual tumors. By genome-wide scanning of hypermethylated genes on head and neck cancer cells, we identified glutathione peroxidase 3 (GPX3) as one of the strong candidates whose promoter hypermethylation may be associated with head and neck chemoresistance. In this study, we investigated the potential predictive value of GPX3 methylation for head and neck cancer chemoresistance and patient prognosis. Methods: Promoter methylation and expression of GPX3 gene in head and neck cancer cell lines were examined by plasmid cloning, bisulfite DNA sequencing, reverse transcription-PCR and Western blot. GPX3 methylation in primary cancer tissues was assessed by real-time methylation-specific PCR (MSP). Forty-six head and neck cancer cases, for which chemotherapy response and survival were known, were selected for analysis. Correlation of GPX3 methylation and chemoresistance was tested using two-sided Fisher’s Exact Test and its prediction for patient survival was assessed using Kaplan-Meier survival analysis. Results: Loss of GPX3 expression was observed in 4 of 8 head and neck cancer cell lines and was consistent with cisplatin resistance. Demethylating treatment of the cell lines negative for GPX3 expression significantly restored its expression. Bisulfite DNA sequencing showed that the 5’ flanking promoter region of GPX3 was heavily hypermethylated in all cell lines with expression-silencing of the gene. In the 46 head and neck cancer cases analyzed by MSP, 15 of 23 non-responding cases (65%) showed GPX3 methylation, while 4 of 23 complete and partial response cases (17%) contained low levels of GPX3 methylation (Relative Risk 3.343, two sided Fisher’s exact test, P=0.002). Kaplan-Meier survival analysis showed a relative risk of death of 1.942 in patients with GPX3 methylation. Conclusions: Our findings suggest that GPX3 methylation is a strong candidate predictor for chemoresistance and prognosis of head and neck cancer patients. No significant financial relationships to disclose.

Oral mucositis prevention by low-level laser therapy in head and neck cancer patients submitted to concurrent chemoradiation: A prospective randomized study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6019-6019
Author(s):  
G. Castro ◽  
A. G. de Lima ◽  
D. R. Lopes ◽  
M. V. Ortegosa ◽  
M. C. Rosalmeida ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Oral Cavity ◽  
Head And Neck ◽  
Neck Cancer ◽  
Oral Mucositis ◽  
Primary Site ◽  
Low Level ◽  
Low Level Laser ◽  
Level Laser ◽  
Grade 3

6019 Background: Oral mucositis is a major treatment-related complication of concurrent chemoradiation (CRT) in head and neck cancer (HNC) patients (pts), affecting nutrition, pain control, quality of life and adequate treatment delivery. Low level laser (LLL) is a promising preventive therapy. We aimed to evaluate the efficacy of LLL to decrease and delay severe oral mucositis and its impact on RT interruptions. Methods: In this prospective, randomized, double-blind, phase III trial, pts were treated with either daily He-Ne LLL 2.5 J/cm2, or placebo laser, before RT. Eligible pts had to be diagnosed with SCC or undifferentiated carcinoma of oral cavity, pharynx, larynx, or metastatic to the neck with unknown primary site (UPS); age > 18 y; candidates to adjuvant or definitive CRT; signed informed consent. CRT consisted of conventional RT 60–70 Gy (1.8–2.0 Gy/d, 5 times/wk) + concurrent cisplatin 100 mg/m2 every 3 wks. Main endpoints were oral mucositis severity in wks 2, 4 and 6 (CTC-NCI v.2.0); RT interruptions due to mucositis; pain intensity (VAS). To detect a decrease in the incidence of grade 3 or 4 oral mucositis from 80 to 50%, we planned to enroll 74 pts, error I/II 5 and 20%, respectively. Results: 73 pts were included (77% male; mean age 53 y); primary site: oropharynx (31 pts), larynx (15), nasopharynx (10), hypopharynx (8), oral cavity (7 pts), UPS (2); 36 pts received prophylactic LLL. Mean delivered RT dose (Gy) was higher in pts treated with LLL (69.3 vs. 67.8, p = 0.04). The number of treatment fields was the same (6 vs. 6, p = 0.50) and the mean cisplatin dose-intensity was 40.9 and 40.1 mg/m2/wk (p = 0.3) between pts treated with LLL or placebo, respectively. During CRT, the number of pts diagnosed with grade 3 or 4 oral mucositis treated with LLL/placebo was 4/5 (wk 2, p = 1.0); 4/11 (wk 4, p = 0.08); and 8/9 (wk 6, p = 1.0), respectively. More pts treated with placebo had RT interruptions due to mucositis (6 vs. 0, p =0.02). The occurrence of severe pain did not differ between the study arms in wks 2, 4 and 6 (5/5, 8/8 and 8/8, p = 1.0). Conclusions: LLL therapy was effective in reducing grade 3 or 4 oral mucositis and in reducing RT interruptions in these HNC pts treated with concurrent CRT, which may translate into improved CRT efficacy and tolerance. No significant financial relationships to disclose.

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