Supportive care in cancer: Impact of marital status on outcome of end-stage head and neck cancer.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 18-18
Author(s):  
Matthew C Simpson ◽  
Aleksandr R Bukatko ◽  
Allison P Knewitz ◽  
Connor L Donovan ◽  
Eric Adjei Boakye ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Marital Status ◽  
Head And Neck ◽  
Neck Cancer ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Never Married ◽  
Hazards Model ◽  
End Stage ◽  
The Impact

18 Background: The impact of marital status on cancer survival, including head and neck cancer (HNC), has been previously described. However, no previous study has shown whether being married impacts head and neck cancer patients with end-stage disease. The objective of this study was to determine the impact of marital status on survival of patients with stage IVc HNC. Methods: Patients ≥18 years from the Surveillance, Epidemiology, and End Results (SEER) database diagnosed with end-stage (AJCC stage IVc) head and neck squamous cell carcinoma from 2007-2015 ( n=2,886) were included. Kaplan-Meier survival estimated crude survival differences stratified by marital status (married/partnered, never married, divorced/separated, widowed) using log-rank test, and in-between differences were determined using Bonferroni adjustments. Competing risks proportional hazards model determined the effect of marital status on death from HNC while controlling for covariates (age, year of diagnosis, county-level poverty percentage, sex, race/ethnicity, insurance, anatomic subsite, and treatment modality). Results: Patients were predominantly male (81%) and white (65%), with mean age of 62 years. Median overall survival for the cohort was 11 months. The Kaplan-Meier curves indicated at the end of follow-up that divorced/separated (HNSCC-specific survival percentage=13%), never married (8%), and widowed patients (12%) had significantly lower survival than married/partnered patients (20%) (Bonferroni p<0.01). After adjusting for covariates, the proportional hazards model indicated that divorced/separated (aHR=1.16, 95% CI 1.01, 1.33), never married (aHR=1.20, 95% CI 1.07, 1.36), and widowed patients (aHR=1.23, 95% CI 1.02, 1.48) were significantly more likely to die from HNSCC than married/partnered patients. Conclusions: Married patients with HNC enjoy better survival outcomes than those unmarried, and those widowed and divorced have worse outcomes. This study illustrates that supportive care, in the form of being married, impacts patients, including those with end-stage disease.

scholarly journals Second Primary Oral Squamous Cell Carcinoma After Radiotherapy: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Hao Song ◽  
Ranran Yang ◽  
Kailiu Wu ◽  
Chao Lou ◽  
Meng Xiao ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Clinicopathological Characteristics ◽  
Cox Proportional Hazards ◽  
Margin Status ◽  
Cox Proportional Hazards Model ◽  
Second Primary

Abstract Background：The clinical characteristics of second primary tumors in oral cavity after radiation was a special subtype of oral cancer and remained poorly studied. The purpose of the present study was to investigate the clinicopathological characteristics and prognostic factors of second primary oral squamous cell carcinoma (OSCC) after radiotherapy for head and neck cancer.Methods：The clinicopathological characteristics of 48 OSCC patients underwent radiotherapy for head and neck cancer were retrospectively analyzed by Kaplan-Meier survival analysis and Cox proportional hazards model, including gender, age, alcohol consumption, smoking, clinical stage, margin status, regional lymph node status, tumor differentiation and treatment mode.Results：The second primary OSCC mostly occurred on the tongue (18/48), bucca (12/48) and gingiva (10/48), and the 3- and 5-year overall survival (OS) was 60.3% and 39.4%, respectively. Margin status (p=0.001, log-rank=10.777) and extranodal extension (p=0.045, log-rank=4.017) were significantly associated with OS, while only margin status was found to be an independent prognostic factor of OS in the Cox proportional hazards model (p=0.003, HR=3.976).Conclusions： OSCC patients underwent radiotherapy for head and neck cancer show poor survival outcomes. Margin status is an independent prognostic factor of second primary OSCC, and the prognostic of second primary OSCC was not in accordance with sporadic OSCC.

scholarly journals Influence of Tourism Seasonality and Financial Ratios on Hotels’ Exit Risk

2021 ◽  
pp. 109634802110160
Author(s):  
Dengjun Zhang ◽  
Jinghua Xie
Keyword(s):  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Hotel Industry ◽  
Financial Ratios ◽  
Market Segment ◽  
Tourism Demand ◽  
Hazards Model ◽  
Two Measures ◽  
The Impact

Tourism seasonality negatively affects hotels’ operational and financial performance and then survival probabilities. Several studies have evaluated the impact of tourism seasonality on hotels’ exit risk. However, the empirical findings are ambiguous, probably due to the overall seasonality and different measures used in these studies. Against this background, this study explores the impact of tourism seasonality on hotel firms’ exit risk, using a proportional hazards model. We controlled for financial ratios, the main factors influencing the exit risk, and used two measures of tourism seasonality by market segment, namely, leisure, business, and conference tourism. The case study is the Norwegian hotel industry. The empirical results suggest that the different seasonal patterns of tourism demand in the market segments mitigate the impact of the overall seasonality on hotels’ exit risk, and that seasonality measures of various tourism segments affect the exit risk in different ways.

The impact of coronavirus disease 2019 on suspected head and neck cancer two-week-wait referrals

2021 ◽  
pp. 1-10
Author(s):  
N Bhamra ◽  
B Gorman ◽  
W Arnold ◽  
A Rajah ◽  
K Jolly ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
The Impact

scholarly journals Increasing Mean Age of Head and Neck Cancer Patients at a German Tertiary Referral Center

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 832
Author(s):  
Julius M. Vahl ◽  
Marlene C. Wigand ◽  
Michael Denkinger ◽  
Dhayana Dallmeier ◽  
Chiara Steiger ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Catchment Area ◽  
Incidence Rates ◽  
Cancer Center ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Referral Center ◽  
The Impact

Background: The impact of demographic change on the age at diagnosis in German head and neck cancer (HNC) patients is unclear. Here we present an evaluation of aging trends in HNC at a tertiary referral center. Methods: Retrospective cohort study on aging trends at the initial diagnosis of newly diagnosed patients with HNC between 2004 and 2018 at the head and neck cancer center Ulm in relation to demographic data of the catchment area. Results: The study population consisted of 2450 individuals diagnosed with HNC with a mean age of 62.84 (±11.67) years. We observed a significant increase in annual incidence rates and mean age over time. Mean age among HNC patients increased significantly more than among the population in the catchment area. Whereas the incidence rate of patients <50 years did not change, the incidence of HNC patients aged ≥70 years increased the most. The mean patient age in the main tumor sites increased significantly. Surprisingly, HPV-positive patients were not younger than HPV-negative patients, but showed a non-significant trend towards a higher mean age (63.0 vs. 60.7 years). Conclusions: Increasing incidence rates in older patients pose a challenge for health care systems. A nationwide study is needed to assess the dynamics and impact of aging on the incidence of HNC.

scholarly journals Impacts of Environmental Factors on Head and Neck Cancer Pathogenesis and Progression

Cells ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 389
Author(s):  
Marisol Miranda-Galvis ◽  
Reid Loveless ◽  
Luiz Paulo Kowalski ◽  
Yong Teng
Keyword(s):  
Head And Neck Cancer ◽  
Environmental Factors ◽  
Head And Neck ◽  
Neck Cancer ◽  
Molecular Mechanisms ◽  
Metastatic Cancer ◽  
Environmental Drivers ◽  
Cancer Pathogenesis ◽  
Gene Environment ◽  
The Impact

Epidemiological and clinical studies over the past two decades have provided strong evidence that genetic elements interacting with environmental components can individually and collectively influence one’s susceptibility to cancer. In addition to tumorigenic properties, numerous environmental factors, such as nutrition, chemical carcinogens, and tobacco/alcohol consumption, possess pro-invasive and pro-metastatic cancer features. In contrast to traditional cancer treatment, modern therapeutics not only take into account an individual’s genetic makeup but also consider gene–environment interactions. The current review sharpens the focus by elaborating on the impact that environmental factors have on the pathogenesis and progression of head and neck cancer and the underlying molecular mechanisms involved. Recent advances, challenges, and future perspectives in this area of research are also discussed. Inhibiting key environmental drivers of tumor progression should yield survival benefits for patients at any stage of head and neck cancer.

Lymphoedema after head and neck cancer treatment: an overview for clinical practice

2021 ◽  
Vol 26 (Sup4) ◽  
pp. S24-S29
Author(s):  
Claire Jeans ◽  
Bena Brown ◽  
Elizabeth C Ward ◽  
Anne E Vertigan
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Lymphatic System ◽  
Review Article ◽  
Psychological Issues ◽  
Wide Range ◽  
The Face ◽  
Protein Rich ◽  
The Impact

Lymphoedema is a disorder of the lymphatic system that presents as an atypical swelling and accumulation of protein-rich fluid within the interstitial spaces. Head and neck lymphoedema (HNL) is highly prevalent in patients who have been treated for head and neck cancer (HNC) and may manifest externally on the face and neck; internally within the oral cavity, pharynx or larynx; or as a combination of both. HNL is known to contribute to a wide range of physical, functional and psychological issues, and presents several unique challenges in terms of its management. This review article provides an overview of HNL for clinicians and aims to improve awareness of this condition and the impact it has on patients.

scholarly journals Adaptive radiotherapy for head and neck cancer

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Enis Tinjak ◽  
Velda Smajlbegović ◽  
Adnan Beganović ◽  
Mirjana Ristanić ◽  
Halil Ćorović ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Locally Advanced ◽  
Adaptive Radiotherapy ◽  
Tumor Control ◽  
Parotid Glands ◽  
Image Guided Radiotherapy ◽  
The Impact

Introduction: Radiation therapy has long played an integral role in the manage¬ment of locally advanced head and neck cancer (HNC), both for organ preservation and to improve tumor control in the postoperative setting. The aim of this research is to investigate the effects of adaptive radiotherapy on dosimetric, clinical, and toxicity outcomes for patients with head and neck cancer undergoing radiation therapy treatment. Many sources have reported volume reductions in the primary target, nodal volumes, and parotid glands over treatment, which may result in unintended dosimetric changes affecting the side effect profile and even efficacy of the treatment. Adaptive radiotherapy (ART) is an interesting treatment paradigm that has been developed to directly adjust to these changes.Material and methods: This research contains the results of 15 studies, including clinical trials, randomized prospective and retrospective studies. The researches analyze the impact of radiation therapy on changes in tumor volume and the relationship with planned radiation dose delivery, as well as the possibility of using adaptive radiotherapy in response to identified changes. Also, medical articles and abstracts that are closely related to the title of adaptive radiotherapy were researched.Results: The application of ART significantly improved the quality of life of patients with head and neck cancer, as well as two-year locoregional control of the disease. The average time to apply ART is the middle of the treatment course approximately 17 to 20 fractions of the treatment.Conclusion: Based on systematic review of the literature, evidence based changes in target volumes and dose reduction at OAR, adaptive radiotherapy is recommended treatment for most of the patients with head and neck cancer with the support of image-guided radiotherapy.

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