Summary This is a study of 5595 head and neck cancer patients treated during 1987-89 at TMH, Mumbai. The study included 1970 oral cancers , 1495 oropharyngeal cancers (ICD 1410(ICD , 1453, 1255 hypopharyngeal cancers (ICD 148), 125 nasopharyngeal cancers (ICD 147) and 750 laryngeal cancers (ICD 161). The clinical extent of disease at presentation was based on TNM group staging (UICC 1978). For the majority of sites, patients attended the hospital during stage IlIl and stage IV of the disease; the only exception was for cancers of the lower lip, anterior tongue and vocal cord when between 46.2% and 56.5% of patients with localized cancer (stage and 11) were seen. Generally, surgery either alone or with radiation has been administered for oral cancer patients whereas radiation either alone or in combination with chemotherapy was administered for other head and neck sites. The overall 5-year survival rate was in the range of 20-43% for oral cancer, 8-25% for pharyngeal cancers and 25-62% for laryngeal cancer. The 5-year relative survival rates were more or less in agreement with the results published by the Eurocare study for head and neck cancers. The importance of primary prevention in head and neck cancer is stressed.Keywords: head and neck cancer; survival; TNM; stage; treatment Incidence data that are available from six metropolitan cities and one rural registry in India indicate that head and neck cancer is a common problem there (IARC, 1992). Many epidemiological studies carried out in the sub-continent have shown the association of tobacco, alcohol and some dietary items with head and neck cancer. Although primary prevention may be the ideal choice for the control of head and neck cancer, secondary prevention through therapeutic intervention has an equal and important role to play. Management of head and neck cancer in a high-risk population and its response to conventional treatment and survival have not been reported in detail. The aim is to analyse individual sites of head and neck cancer according to stage of the disease, primary treatment and other prognostic factors for 5-year survival.Comparison is also made with survival in European countries. PATIENTS AND METHODSThis is a retrospective analysis of 5595 eligible head and neck cancer patients who were diagnosed and treated at Tata Memorial Hospital, Mumbai, during the period 1987-89. The eligibility criteria for inclusion of patients in the study were: (1) no prior cancer-directed treatment at the time of registration; (2) histologically confirmed epithelial cancer; (3) treatment with chemotherapy together with surgery or radiation but not as the only treatment; and (4) at least 50 cases in each subsite of head and neck cancer. The excluded subsites MO and T2 N MO and stage IV comprising T4No MO, T4 N MO, and any T, N2 or N3 MO and any T any N M,. Periodic updating of followup information was carried out either by scrutiny of medical records of attending patients or by postal enquiry responses. In some cases, follow-up information was also obtaine...

Atopic disease occurs in solid organ transplant recipients with an increasingly recognized frequency. The time course for the development of these atopic diseases in liver transplantation has not been described. The objective was to characterize the atopic manifestations of children receiving chronic immunosuppression after orthotopic liver transplantation (OLT). Chart review and follow-up questionnaire were utilized for 176 OLT pediatric recipients at a single institution for manifestations of allergic disease. Atopic disease was present in 25 (14.2%) patients. Median age at transplant was 16 months with a median follow-up of 63 months. Food allergy and non-food related atopic symptoms presented at a median of 11.5 (IQR, 6-28) and 19 (IQR, 5-41) months post-transplantation, respectively. The median age at transplant of the non-atopic children was 72 months, higher than patients with atopy (p < 0.001). Food allergy and atopic skin disease symptoms were present in 40% and 56% of cases, respectively. Asthma, allergic rhinitis, or both were found in 66% of cases. The onset of symptoms of food allergy and eczema (median, 12 months post-transplantation) preceded symptoms of allergic rhinitis and asthma. (median of 27 and 30 months post-transplantation, respectively). Atopy occurs in ∼14% of pediatric liver transplant recipients, with manifestations including food allergy, eczema, allergic rhinitis, and asthma.