TY - JOUR
T1 - The influence of smoking, age and stage at diagnosis on the survival after larynx, hypopharynx and oral cavity cancers in Europe
T2 - The ARCAGE study
AU - Abrahão, Renata
AU - Anantharaman, Devasena
AU - Gaborieau, Valérie
AU - Abedi-Ardekani, Behnoush
AU - Lagiou, Pagona
AU - Lagiou, Areti
AU - Ahrens, Wolfgang
AU - Holcatova, Ivana
AU - Betka, Jaroslav
AU - Merletti, Franco
AU - Richiardi, Lorenzo
AU - Kjaerheim, Kristina
AU - Serraino, Diego
AU - Polesel, Jerry
AU - Simonato, Lorenzo
AU - Alemany, Laia
AU - Agudo Trigueros, Antonio
AU - Macfarlane, Tatiana V.
AU - Macfarlane, Gary J.
AU - Znaor, Ariana
AU - Robinson, Max
AU - Canova, Cristina
AU - Conway, David I.
AU - Wright, Sylvia
AU - Healy, Claire M.
AU - Toner, Mary
AU - Cadoni, Gabriella
AU - Boccia, Stefania
AU - Gheit, Tarik
AU - Tommasino, Massimo
AU - Scelo, Ghislaine
AU - Brennan, Paul
N1 - European Commission’s 5th Framework Program (Paul Brennan, Principal Investigator, contract QLK1-2011-00182), European Commission’s 7th Framework Program (Massimo Tomassimo Principal Investigator, contract FP7-HEALTH-2011-282562), and Health General Directorate of the French Social Affairs and Health Ministry)
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Head and neck cancer (HNC) is a preventable malignancy that continues to cause substantial morbidity and mortality worldwide. Using data from the ARCAGE and Rome studies, we investigated the main predictors of survival after larynx, hypopharynx and oral cavity (OC) cancers. We used the Kaplan-Meier method to estimate overall survival, and Cox proportional models to examine the relationship between survival and sociodemographic and clinical characteristics. 604 larynx, 146 hypopharynx and 460 OC cancer cases were included in this study. Over a median follow-up time of 4.6 years, nearly 50% (n=586) of patients died. Five-year survival was 65% for larynx, 55% for OC, and 35% for hypopharynx cancers. In a multivariable analysis, we observed an increased mortality risk among older (≥71 years) vs. younger (≤50 years) patients with larynx/hypopharynx combined (LH) and OC cancers [HR=1.61, 95% CI 1.09-2.38 (LH) and HR=2.12, 95% CI 1.35-3.33 (OC)], current vs. never smokers [HR=2.67, 95% CI 1.40-5.08 (LH) and HR=2.16, 95% CI 1.32-3.54 (OC)], and advanced vs. early stage disease at diagnosis [IV vs. I, HR=2.60, 95% CI 1.78-3.79 (LH) and HR=3.17, 95% CI 2.05-4.89 (OC)]. Survival was not associated with sex, alcohol consumption, education, oral health, p16 expression, presence of HPV infection, or body mass index 2 years before cancer diagnosis. Despite advances in diagnosis and therapeutic modalities, survival after HNC remains low in Europe. In addition to the recognized prognostic effect of stage at diagnosis, smoking history and older age at diagnosis are important prognostic indicators for HNC. This article is protected by copyright. All rights reserved.
AB - Head and neck cancer (HNC) is a preventable malignancy that continues to cause substantial morbidity and mortality worldwide. Using data from the ARCAGE and Rome studies, we investigated the main predictors of survival after larynx, hypopharynx and oral cavity (OC) cancers. We used the Kaplan-Meier method to estimate overall survival, and Cox proportional models to examine the relationship between survival and sociodemographic and clinical characteristics. 604 larynx, 146 hypopharynx and 460 OC cancer cases were included in this study. Over a median follow-up time of 4.6 years, nearly 50% (n=586) of patients died. Five-year survival was 65% for larynx, 55% for OC, and 35% for hypopharynx cancers. In a multivariable analysis, we observed an increased mortality risk among older (≥71 years) vs. younger (≤50 years) patients with larynx/hypopharynx combined (LH) and OC cancers [HR=1.61, 95% CI 1.09-2.38 (LH) and HR=2.12, 95% CI 1.35-3.33 (OC)], current vs. never smokers [HR=2.67, 95% CI 1.40-5.08 (LH) and HR=2.16, 95% CI 1.32-3.54 (OC)], and advanced vs. early stage disease at diagnosis [IV vs. I, HR=2.60, 95% CI 1.78-3.79 (LH) and HR=3.17, 95% CI 2.05-4.89 (OC)]. Survival was not associated with sex, alcohol consumption, education, oral health, p16 expression, presence of HPV infection, or body mass index 2 years before cancer diagnosis. Despite advances in diagnosis and therapeutic modalities, survival after HNC remains low in Europe. In addition to the recognized prognostic effect of stage at diagnosis, smoking history and older age at diagnosis are important prognostic indicators for HNC. This article is protected by copyright. All rights reserved.
KW - ARCAGE study
KW - head and neck cancer
KW - predictors of survival
U2 - 10.1002/ijc.31294
DO - 10.1002/ijc.31294
M3 - Article
C2 - 29405297
SN - 0020-7136
VL - 143
SP - 32
EP - 44
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 1
ER -