Stage-Wise Presentation of Non-Metastatic Head and Neck Cancer: an Analysis of Patients from the Kumaon Hills of India

Abstract

Background: Head and neck cancer without distant metastases is amenable to various modalities of treatment. However, the stage at presentation is a very important determinant for treatment success. The present study was conducted to determine the stage-wise presentation of non-metastatic head and neck cancer patients from the hilly regions in Kumaon division of Uttarakhand, India. Materials and Methods: The hospital records for non-metastatic head and neck cancer patients from the only functional cancer centre of the region for the period of two-years (January 2012-December 2013) were included. Nasopharyngeal carcinoma was excluded due to its staging system being different. Non-squamous histopathologies were also excluded. Patients hailing from nearby regions of Uttar Pradesh and Nepal were excluded, as were patients from non-hilly regions of Kumaon. Results: Of the 271 patients of head and neck cancer, 27 with distant metastases at diagnosis were excluded from the analysis. Of the 244 eligible patient records, 90.1% (n=222) were male, and 9.9% (n=22) were female. The proportions of patients with carcinoma of the larynx, oropharynx, oral cavity, hypopharynx and maxillary antrum were 31.9% (n=78), 27.9% (n=68), 20.5% (n=50), 12.7% (n=31) and 1.2% (n=3). A further 5.7% (n=14) were diagnosed as having secondary involvement of neck nodes with unknown primaries. The proportion of patients presenting in stages I, II, III, IVA and IVB were 0.8% (n=2), 2.5% (n=6), 9.4% (n=23), 51.6% (n=126) and 35.7% (n=87) respectively. Conclusions: An abysmally low proportion (3.3%) of non-metastatic head and neck cancer patients presented in the early stages (I and II). A vast majority of the patients (88.1%) presented with stages IVA and IVB. Not only does this reflect a poor therapeutic outlook, but also exposes the dire need for programmes focusing on cancer awareness and early detection in the region.Keywords: Head and neck cancer -Kumaon -cancer in the Himalayas -Uttarakhand

Cancer Statistics, 2020: Report From National Cancer Registry Programme, India

“…Sites of cancer associated with the use of tobacco, anatomic sites (International Statistical Classification of Diseases and Related Health Problems, 10th revision codes), lip (C00); tongue (C01-C02); mouth (C03-C06); pharynx (C10 and C12-C14); esophagus (C15); larynx (C32); lung (C33-C34); urinary bladder (C67). 33 Thi’puram district, Thiruvananthapuram district.…”

“…Similar to that, a low proportion of patients with head and neck cancer presented in the early stage, and a high proportion (88.1%) were seen in Uttarakhand. 33 Multimodality was the most common treatment given for breast and head and neck cancers. A multi-institutional study estimated that 65% of new head and neck cancers with locally advanced disease did not receive the benefit of optimal treatment, resulting in poor survival.…”

Statistics of Cancer, 2020 in Indian States: A Review on the Report From National Cancer Registry Programme

“…About 66% of the patients with malignant growth were analyzed at the locoregional stage for head-and-neck tumors from HBCRs. Like that, a low extent of patients with head-and-neck malignancy introduced in the beginning phase, and a high extent (88.1%) was seen in Uttarakhand [33]. Multimethodology was the most well-known therapy given for bosom and head-and-neck malignancies.…”

Evaluation of factors in relation with the non-compliance to curative intent radiotherapy among patients of head and neck carcinoma: A study from the Kumaon region of India

“…The region is served by only one functional cancer institute, namely the Swami Rama Cancer Hospital and Research Institute, which is affiliated to the Government Medical College, Haldwani. [ 5 6 ]…”