Alcohol, cigarette smoking predict mortality in head and neck cancer
Overall survival (OS) and head and neck cancer (HNC)-specific survival vary among HNC sites, according to a study. In particular, cigarette smoking is a prognostic factor of OS and HNC-specific survival in patients with cancer of the oral cavity and oropharynx, whereas alcohol consumption is a prognostic factor of both survival outcomes in patients with cancer of the larynx.
Pooled analysis involving 4,759 HNC patients from five studies within the International Head and Neck Cancer Epidemiology Consortium showed that 5-year OS was 51.4 percent for all HNC sites combined. Individually, the rates were 50.3 percent for oral cavity, 41.1 percent for oropharynx, 35 percent for hypopharynx and 63.9 percent for larynx.
In terms of HNC-specific survival, 5-year survival rates were 57.4 percent for all HNC combined, with 54.6 percent for oral cavity, 45.4 percent for oropharynx, 37.1 percent for hypopharynx and 72.3 percent for larynx.
Older age at diagnosis and advanced tumour staging were found to be unfavourable predictors of OS and HNC-specific survival. In laryngeal cancer specifically, low educational level was a negative prognostic factor for OS (high school or lower vs college graduate: hazard ratio [HR], 2.54; 95 percent CI, 1.01 to 6.38), and status and intensity of alcohol drinking for both the OS (current drinkers: HR, 1.73; 1.16 to 2.58) and HNC-specific survival (current drinkers: HR, 2.11; 1.22 to 3.66).
In oropharyngeal cancer, on the other hand, smoking status was an independent unfavourable prognostic factor for OS. Smoking intensity (>20 cigarettes/day: HR, 1.41; 1.03 to 1.92) was also a negative predictor of OS in patients with cancer of the oral cavity.
More studies that involve a large sample of patients and allow the adjustment for the main confounders, including comorbidities, and the lifestyle habits after the diagnosis are needed to define and highlight the differences of HNC subsites in terms of lifestyle-related prognostic factors, researchers said.