National Cancer Database report on cancer of the head and neck: 10‐Year update

Cooper, Jay S.; Porter, Kim; Mallin, Katherine; Hoffman, Henry T.; Weber, Randal S.; Ang, K. Kian; Langer, Corey J.

doi:10.1002/hed.21022

Cited by 366 publications

(284 citation statements)

References 14 publications

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“…When patients were compared by treatment era (pre-2000 and post-2000), no change was observed in the distributions of age, sex, and comorbidity (p = 0.92, 0.28, 0.44 respectively). Figure 1 demonstrates the declining incidence of hpc over time, consistent with other studies [29][30][31][32] .…”

Section: The Lateral Wall Sub-site Has No Assigned International Statsupporting

confidence: 88%

Did the Addition of Concomitant Chemotherapy to Radiotherapy Improve Outcomes in Hypopharyngeal Cancer? A Population-Based Study

Hall

Griffiths

2016

Current Oncology

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Section: The Lateral Wall Sub-site Has No Assigned International Statsupporting

confidence: 88%

Did the Addition of Concomitant Chemotherapy to Radiotherapy Improve Outcomes in Hypopharyngeal Cancer? A Population-Based Study

Hall

Griffiths

2016

Current Oncology

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“…Over a similar period, reports from the U.S. Surveillance, Epidemiology, and End Results database and the Netherlands Cancer Registry both showed nonsignificant marginal improvements (4%-6%) in 5-year relative survival (approximately 33% in both studies) in hpc 16,17 . In laryngeal scc, no survival improvement or slightly declining survival was seen 2,16,17 . Those observations contrast with the marked 12%-22% survival improvement found in oropharyngeal scc, likely driven by the epidemiologic increase in hpv (human papillomavirus) as the cause of the disease, a molecularly distinct and clinically favourable entity compared with hpv-negative head-and-neck scc [16][17][18][19][20] .…”

mentioning

confidence: 91%

“…Disappointingly, long-term survival in hpc has not shifted beyond its historical 30% 2,3 . Thus, innovative therapies are urgently needed to improve outcomes in this treatment-resistant disease.…”

mentioning

confidence: 99%

Hypopharyngeal Cancer: Looking Back, Moving Forward

2016

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Population-based datasets can provide observational insights into cancer incidence, patterns of care, and trends in survival outcomes. They can be particularly valuable in rare cancers for which there can be a paucity of prospective evidence. In this issue of Current Oncology, Hall describes treatment and survival trends in 1333 patients with squamous cell carcinoma of the hypopharynx (hpc) treated between 1990 and 2010 in Ontario, based on data from the Ontario Cancer Registry, with linkages to three other administrative datasets 1 .As a rare malignancy, hpc accounts for fewer than 5% of head-and-neck cancers and portends a poor prognosis, driven by patient, anatomic, and disease factors 2 . Patients with hpc have high rates of tobacco-and alcohol-related comorbidities and second cancers and frequently come from lower socioeconomic backgrounds 3,4 . Late presentation is typical, with approximately 70%-90% of patients having stage iii or iv disease at the time of presentation, and is at least in part attributable to the anatomy and location of the hypopharynx 3-6 . The underlying disease-related biologic factors are less well understood, but compared with other head-and-neck sites, hpcs have high rates of multicentricity, submucosal spread, and regional and distant metastasis 7 . In retrospective series, approximately 60% of patients treated with curative intent experience disease relapse or residual disease, and up to 50% of recurrences involve distant failure 3,4 .Evidence-based practice in hpc is challenged by the low incidence of the disease and is largely based on extrapolations from clinical trials in laryngeal squamous cell carcinoma (scc) and subgroup analyses of multi-site head-and-neck scc trials. Despite the substantial heterogeneity in study methods and characteristics, randomized trials comparing concurrent chemoradiation with radiation alone or radiation after induction chemotherapy in locally advanced head-and-neck scc have generally demonstrated improved local outcomes, including larynx preservation, with inconsistent conclusions on survival benefit [8][9][10][11][12] . The Meta-Analysis of Chemotherapy in Head and Neck Cancer collaborative group, in a subgroup analysis of 2767 hpc patients, found a 5-year absolute survival improvement of 4% associated with concomitant chemotherapy (hazard ratio: 0.85; 95% confidence interval: 0.75 to 0.96) compared with radiotherapy alone 13 . Thus, based on those data and equipoise on optimal treatment, a shift from open surgery toward multimodality approaches for organ preservation has occurred in hpc despite the greater risk of acute and potentially chronic toxicities from concomitant chemotherapy 14,15 .Consistent with other population-based series, Hall observed an increase in the prevalence of concurrent chemoradiation in the post-2000 era and a decrease in the use of primary surgery or radiation alone, with no statistically significant difference in overall survival between the treatment groups 1,2 . Hall's main finding is the lack of a survival increment...

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“…Oral cancer comprises nearly 30% of all HNSCC. Of these, approximately 90% of cases are squamous cell carcinomas (2). Oral squamous cell carcinoma (OSCC) is a major health problem worldwide, and patients have a particularly poor 5-year survival rate (3).…”

Section: Introductionmentioning

confidence: 99%