The Burden of Recurrent Head and Neck Squamous Cell Carcinoma Across the United Kingdom: Results From a National Snapshot Study.

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2024-12-27 DOI:10.1002/hed.28045

Andrew Williamson, Alison E Lim, Freddie Green, Ying Ki Lee, Lucy Li, Christy Moen, Rishi Vasanthan, Olivia Wharf, Jeremy Wong, Vinidh Paleri

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引用次数: 0

Abstract

Background: To investigate the management of recurrent head and neck squamous cell carcinoma (rHNSCC) and describe survival outcomes.

Methods: Post hoc subgroup analysis of a retrospective national observational cohort was conducted. All patients with rHNSCC who received a definitive treatment decision between September 1, 2021 and November 30, 2021 were included. Survival analysis was stratified according to subsite, primary versus recurrent disease, and surgical versus nonsurgical treatment.

Results: Data from 202 rHNSCC patients were derived from a cohort of 1488 patients submitted by 50 UK centers. Median age was 66 years (IQR 58-74), and 142 (70.3%) were male. The most common recurrence subsites were oropharynx (20.5%), oral cavity (19.5%), larynx (16.4%), and hypopharynx (14.9%). Ninety-three (48.4%) were managed curatively. Surgery was the most common treatment for laryngeal (59.4%), oral cavity (60.5%), hypopharyngeal (44.8%), and oropharyngeal (37.5%) cancers. Two-year overall (OS), disease-free (DFS), disease-specific (DSS), and local recurrence free survival (LRFS) were 41.1%, 39.1%, 42.2%, and 39.3%, respectively. rHNSCC treated with surgery had improved OS (p = 0.0005), DFS (p = 0.012), DSS (p = 0.0003), and LRFS (p = 0.007), over nonsurgical treatments. Compared to primary cancers, rHNSCC presents with more advanced T stage (p < 0.001) and distant metastasis (p < 0.001), receives less curative treatment (p < 0.001), and has worse survival outcomes (all p < 0.001). On multivariate analysis, salvage surgery, radiotherapy, and p16 status were independent prognostic factors of all survival outcomes.

Conclusions: Recurrent HNSCC is associated with high rates of incurable disease and worse survival than primary cancers. Surgery remains the most common curative treatment in rHNSCC, however future studies are necessary to improve patient selection and optimize outcomes following salvage treatment.

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英国复发性头颈部鳞状细胞癌的负担：来自全国快照研究的结果。

背景：探讨复发性头颈部鳞状细胞癌（rHNSCC）的治疗方法并描述生存结果。方法：对回顾性国家观察队列进行事后亚组分析。所有在2021年9月1日至2021年11月30日期间接受最终治疗决定的rHNSCC患者均被纳入研究。生存分析根据亚部位、原发与复发、手术与非手术治疗进行分层。结果：202例rHNSCC患者的数据来自50个英国中心提交的1488例患者队列。中位年龄66岁（IQR 58-74），男性142例（70.3%）。最常见的复发部位为口咽部（20.5%）、口腔（19.5%）、喉部（16.4%）和下咽（14.9%）。93例（48.4%）得到有效治疗。手术是喉癌（59.4%）、口腔癌（60.5%）、下咽癌（44.8%）和口咽癌（37.5%）最常见的治疗方法。两年总生存率（OS）、无病生存率（DFS）、疾病特异性生存率（DSS）和局部无复发生存率（LRFS）分别为41.1%、39.1%、42.2%和39.3%。与非手术治疗相比，手术治疗的rHNSCC的OS （p = 0.0005）、DFS （p = 0.012）、DSS （p = 0.0003）和LRFS （p = 0.007）均有改善。与原发癌相比，复发性HNSCC出现更晚期的T期(p)。结论：与原发癌相比，复发性HNSCC的不治之症发生率高，生存率差。手术仍然是rHNSCC最常见的治疗方法，但是未来的研究需要改进患者选择和优化挽救性治疗后的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.