Premium
The influence of smoking, age and stage at diagnosis on the survival after larynx, hypopharynx and oral cavity cancers in E urope: The ARCAGE study
Author(s) -
Abrahão Renata,
Anantharaman Devasena,
Gaborieau Valérie,
AbediArdekani Behnoush,
Lagiou Pagona,
Lagiou Areti,
Ahrens Wolfgang,
Holcatova Ivana,
Betka Jaroslav,
Merletti Franco,
Richiardi Lorenzo,
Kjaerheim Kristina,
Serraino Diego,
Polesel Jerry,
Simonato Lorenzo,
Alemany Laia,
Agudo Trigueros Antonio,
Macfarlane Tatiana V.,
Macfarlane Gary J.,
Znaor Ariana,
Robinson Max,
Canova Cristina,
Conway David I.,
Wright Sylvia,
Healy Claire M.,
Toner Mary,
Cadoni Gabriella,
Boccia Stefania,
Gheit Tarik,
Tommasino Massimo,
Scelo Ghislaine,
Brennan Paul
Publication year - 2018
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.31294
Subject(s) - medicine , larynx , cancer , proportional hazards model , head and neck cancer , malignancy , stage (stratigraphy) , survival analysis , surgery , gastroenterology , oncology , paleontology , biology
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) versus 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 versus 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 versus early stage disease at diagnosis [IV versus 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.