Cancers of the upper aerodigestive tract in Ontario, Canada, and the United States

Skarsgard, David; Groome, Patti A.; MacKillop, Jim; Zhou, Shutang; Rothwell, Deanna M.; Dixon, F M B Peter; O'Sullivan, M B Brian; Hall, Steven F.; Holowaty, Eric J.

doi:10.1002/(sici)1097-0142(20000401)88:7<1728::aid-cncr29>3.0.co;2-7

Cited by 74 publications

(59 citation statements)

References 18 publications

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“…Glandular carcinomas were found in 4% of them. All these numbers agree with other Brazilian 4,20 and with foreign 21,22 studies. Local advanced disease was more frequent than initial disease (39.7% for T4 versus 15.2% for T1 plus Tis).…”

Section: Discussionsupporting

confidence: 92%

Clinical and Epidemiological Features of Oral Cancer in a Medical School Teaching Hospital From 1994 to 2002: Increasing Incidence in Women, Predominance of Advanced Local Disease, and Low Incidence of Neck Metastases

Durazzo

Araujo

Neto

et al. 2005

Clinics

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RESULTS:A total of 374 patients having undergone 406 operations was identified. Their ages varied from 14 to 94 years (mean = 57.4 years), with 255 men (68.2%), and 295 out 366 Caucasian (80.6%). A majority had tumors of the tongue and/ or floor of mouth (55.6%), while 20.3% had lip cancer. Squamous cell carcinoma was found in 90.3%, and glandular carcinoma in 4%. T4 tumors in 39.6%, Tis or T1 lesions in 15.2% of all patients. Nearly 62% had no regional metastases, and the relative incidence in young patients (40 years or younger) reached 8.6%. CONCLUSION: In spite of the predominance of locally advanced tumors, a majority of patients had no neck metastases. The 31.8% incidence in females indicates an increasing incidence of oral cavity cancer among women when compared to previous periods at the same institution. KEYWORDS: Head and neck neoplasms. Mouth neoplasms. Neoplasm metastasis. Population at risk. Epidemiology.Cancer of the oral cavity represents 2.6% of all malignancies affecting the Brazilian population according an estimate from the Brazilian National Cancer Institute (INCa) for 2003. Oral cancer is the eighth most common cancer in Brazil and occupies the sixth place when only men are considered. Regarding mortality, a total of 2.8% of deaths by cancer was due to malignancies in the mouth, which places oral cancer in the ninth place for mortality among all malignant tumors.

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Section: Discussionsupporting

confidence: 92%

Clinical and Epidemiological Features of Oral Cancer in a Medical School Teaching Hospital From 1994 to 2002: Increasing Incidence in Women, Predominance of Advanced Local Disease, and Low Incidence of Neck Metastases

Durazzo

Araujo

Neto

et al. 2005

Clinics

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“…The lung is the most common site for distant metastases. Thus, our current data and the overall literature support the notion that ADSC is more clinically aggressive than typical head and neck SCC, for which only 10-15% of patients develop distant metastases [42,43], and which has a 5 years relative overall survival of approximately 50% [44]. Recent studies have demonstrated that head and neck SCC patients, particularly of the oropharynx, have a much better prognosis when their tumors are associated with transcriptionally-active HPV than when they are not [13].…”

Section: Discussionsupporting

confidence: 77%

Adenosquamous Carcinoma of the Head and Neck: Relationship to Human Papillomavirus and Review of the Literature

Masand

El‐Mofty

et al. 2011

Head and Neck Pathol

136

106

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Adenosquamous carcinoma (ADSC) of the head and neck is an aggressive variant of squamous cell carcinoma (SCC). Certain variants of head and neck SCC are human papillomavirus (HPV)-related and have better prognosis. The relationship of HPV to head and neck ADSC has not been investigated. We searched our files for the term ''adenosquamous'' and head and neck subsites and found cases from 1998 to 2009. The requisite histologic criteria were the presence of SCC combined with distinct gland formation and/or intracellular mucin. DNA in situ hybridization for high-risk HPV, RNA in situ hybridization for high risk HPV E6 and E7 transcripts, and immunohistochemistry for p16 and p53 were performed. The existing literature on ADSC was also reviewed. Of the 18 cases, eight were from the larynx and hypopharynx, four from the oral cavity, three from the oropharynx, and three from the nasal cavity. Three cases (16%) showed both high risk HPV E6 and E7 and p16 expression, one from the nasal cavity and two from the oropharynx. Both oropharyngeal carcinoma patients were alive and disease free at 34 and 103 months, respectively. ADSCs of the head and neck are a heterogeneous group of tumors. A small minority of cases harbor HPV and most of these, particularly those occurring at sites with known high prevalence of HPV, show active viral transcription with detectable E6 and E7 and overexpression of p16. The HPV-related oropharyngeal cases, though rare, appear to do very well clinically, while the remaining cohort of ADSC patients do quite poorly. Head and neck ADSC appears to be a mixed variant that can be further classified according to its HPV status.

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“…Hall et al (4) demonstrated that within the first 5 years from diagnosis ϳ1 of 5 patients dies from increased comorbidities. Skarsgard et al (5) calculated that the excess mortality (i.e., expected survival in the general population minus observed survival) for patients registered in the Ontario Cancer Registry in Canada and the Surveillance, Epidemiology, and End Results database in the United States who survived up to 5 years from diagnosis was Ͼ50%, whereas the excess mortality for patients who survived beyond the first 5 years was in the order of 20 -40%. The major impact of noncancer-related causes of death in head and neck cancer is reminiscent of similar findings in patients undergoing chemotherapy for other potentially curable diseases, such as Hodgkin's disease and germ cell tumors (14 -16).…”

Section: Discussionmentioning

confidence: 99%

“…It has been recognized that survivors of head and neck cancer have increased morbidity and mortality compared with the healthy population that relates to treatment sequelae, coexisting pulmonary, cardiac, and liver diseases secondary to smoking and alcohol use, and second primary tumors (1)(2)(3)(4)(5). Currently, with the advent of aggressive combined modality programs disease control in patients even with stage IV head and neck cancer has been optimized; in Phase II trials progression-free survival has exceeded 60% at 3-5 years (6 -13).…”

Section: Introductionmentioning

confidence: 99%

Competing Causes of Death and Second Primary Tumors in Patients with Locoregionally Advanced Head and Neck Cancer Treated with Chemoradiotherapy

Argiris

Brockstein

Haraf

et al. 2004

Clinical Cancer Research

165

125

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Purpose: The purpose of this retrospective analysis was to evaluate the emergence of second primary malignancies and the contribution of different causes of death to the outcome of patients with locoregionally advanced head and cancer receiving primary chemoradiotherapy.Experimental Design: We studied 324 patients with stage IV squamous cell head and neck cancer who were enrolled on five consecutive multicenter Phase II studies of concurrent chemoradiotherapy. All of the regimens included concurrent 5-fluorouracil and hydroxyurea on an alternate week schedule with radiotherapy, either alone (FHX) or with cisplatin (C-FHX) or paclitaxel (T-FHX). The cumulative incidence of second primary tumors or death from any cause was estimated using methods of competing risk analysis.Results: Median follow-up of surviving patients was 5.2 years (2-10.6 years). The 5-year overall survival and progression-free survival of the cohort were 46% and 65%, respectively. Causes of death and median time of occurrence were as follows: disease (n ‫؍‬ 88; 1.5 years), treatmentassociated acute or late complications (n ‫؍‬ 30; 4 months), second primary tumors (n ‫؍‬ 18; 3.5 years), comorbidities (n ‫؍‬ 41; 1.9 years), and unknown (n ‫؍‬ 20; 5.1 years). Predominant causes of death from comorbidities were cardiac and respiratory illnesses. Twenty-six patients (8%) developed a second primary tumor at a median time of 2.8 years (4 months to 10 years). The cumulative incidence of second primary tumors was 5%, 7%, and 13% at 3, 5, and 10 years, respectively. The most frequent site of second primaries was the lung (n ‫؍‬ 13), followed by the esophagus (n ‫؍‬ 3) and head and neck (n ‫؍‬ 2)Conclusions: Patients with locoregionally advanced head and neck cancer treated with concurrent chemoradiotherapy are potentially curable but face significant risks of mortality from causes other than disease progression. Ameliorating toxicity, and implementing secondary screening and chemoprevention strategies are major goals in the management of head and neck cancer.

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Cancers of the upper aerodigestive tract in Ontario, Canada, and the United States

Cited by 74 publications

References 18 publications

Clinical and Epidemiological Features of Oral Cancer in a Medical School Teaching Hospital From 1994 to 2002: Increasing Incidence in Women, Predominance of Advanced Local Disease, and Low Incidence of Neck Metastases

Clinical and Epidemiological Features of Oral Cancer in a Medical School Teaching Hospital From 1994 to 2002: Increasing Incidence in Women, Predominance of Advanced Local Disease, and Low Incidence of Neck Metastases

Adenosquamous Carcinoma of the Head and Neck: Relationship to Human Papillomavirus and Review of the Literature

Competing Causes of Death and Second Primary Tumors in Patients with Locoregionally Advanced Head and Neck Cancer Treated with Chemoradiotherapy

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