The influence of smoking, age and stage at diagnosis on the survival after larynx, hypopharynx and oral cavity cancers in Europe: The ARCAGE study

Renata Abrahão, Devasena Anantharaman, Valérie Gaborieau, Behnoush Abedi-Ardekani, Pagona Lagiou, Areti Lagiou, Wolfgang Ahrens, Ivana Holcatova, Jaroslav Betka, Franco Merletti, Lorenzo Richiardi, Kristina Kjaerheim, Diego Serraino, Jerry Polesel, Lorenzo Simonato, Laia Alemany, Antonio Agudo Trigueros, Tatiana V. Macfarlane, Gary J. Macfarlane, Ariana ZnaorMax Robinson, Cristina Canova, David I. Conway, Sylvia Wright, Claire M. Healy, Mary Toner, Gabriella Cadoni, Stefania Boccia, Tarik Gheit, Massimo Tommasino, Ghislaine Scelo, Paul Brennan

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)32-44
Number of pages13
JournalInternational Journal of Cancer
Volume143
Issue number1
DOIs
Publication statusPublished - Jul 1 2018

Fingerprint

Hypopharynx
Mouth Neoplasms
Larynx
Mouth
Smoking
Survival
Head and Neck Neoplasms
Neoplasms
Mortality
Oral Health
Proportional Hazards Models
Alcohol Drinking
Body Mass Index
History
Morbidity
Education
Infection

Keywords

  • ARCAGE study
  • head and neck cancer
  • predictors of survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

The influence of smoking, age and stage at diagnosis on the survival after larynx, hypopharynx and oral cavity cancers in Europe : The ARCAGE study. / Abrahão, Renata; Anantharaman, Devasena; Gaborieau, Valérie; Abedi-Ardekani, 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.

In: International Journal of Cancer, Vol. 143, No. 1, 01.07.2018, p. 32-44.

Research output: Contribution to journalArticle

Abrahão, R, Anantharaman, D, Gaborieau, V, Abedi-Ardekani, B, Lagiou, P, Lagiou, A, Ahrens, W, Holcatova, I, Betka, J, Merletti, F, Richiardi, L, Kjaerheim, K, Serraino, D, Polesel, J, Simonato, L, Alemany, L, Agudo Trigueros, A, Macfarlane, TV, Macfarlane, GJ, Znaor, A, Robinson, M, Canova, C, Conway, DI, Wright, S, Healy, CM, Toner, M, Cadoni, G, Boccia, S, Gheit, T, Tommasino, M, Scelo, G & Brennan, P 2018, 'The influence of smoking, age and stage at diagnosis on the survival after larynx, hypopharynx and oral cavity cancers in Europe: The ARCAGE study', International Journal of Cancer, vol. 143, no. 1, pp. 32-44. https://doi.org/10.1002/ijc.31294
Abrahão, Renata ; Anantharaman, Devasena ; Gaborieau, Valérie ; Abedi-Ardekani, 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. / The influence of smoking, age and stage at diagnosis on the survival after larynx, hypopharynx and oral cavity cancers in Europe : The ARCAGE study. In: International Journal of Cancer. 2018 ; Vol. 143, No. 1. pp. 32-44.
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AU - Gaborieau, Valérie

AU - Abedi-Ardekani, Behnoush

AU - Lagiou, Pagona

AU - Lagiou, Areti

AU - Ahrens, Wolfgang

AU - Holcatova, Ivana

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AU - Richiardi, Lorenzo

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AU - Agudo Trigueros, Antonio

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