Tumour stage and gender predict recurrence and second primary malignancies in head and neck cancer: a multicentre study within the INHANCE consortium

Emanuele Leoncini, Vladimir Vukovic, Gabriella Cadoni, Luca Giraldi, Roberta Pastorino, Dario Arzani, Livia Petrelli, Victor Wünsch-Filho, Tatiana Natasha Toporcov, Raquel Ayub Moyses, Keitaro Matsuo, Cristina Bosetti, Carlo la Vecchia, Diego Serraino, Lorenzo Simonato, Franco Merletti, Paolo Boffetta, Mia Hashibe, Yuan Chin Amy Lee, Stefania Boccia

Research output: Contribution to journalArticlepeer-review

Abstract

Recurrence and second primary cancer (SPC) continue to represent major obstacles to long-term survival in head and neck cancer (HNC). Our aim was to evaluate whether established demographics, lifestyle-related risk factors for HNC and clinical data are associated with recurrence and SPC in HNC. We conducted a multicentre study by using data from five studies members of the International Head and Neck Cancer Epidemiology consortium—Milan, Rome, Western Europe, Sao Paulo, and Japan, totalling 4005 HNC cases with a median age of 59 (interquartile range 52–67). Multivariate hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for recurrence and SPC. During follow-up, 1161 (29%) patients had recurrence and 343 (8.6%) developed SPC. Advanced tumour stage was associated with increased risk of recurrence in HNC overall (HR = 1.76, 95% CI 1.41–2.19). Women with laryngeal cancer had a reduced risk of recurrence compared to men (HR = 0.39, 95% CI: 0.24–0.74). Concerning predictors of SPC, advanced age (HR = 1.02; 95% CI: 1.00–1.04) and alcohol consumption (> 1 drink per day, HR = 2.11; 95% CI: 1.13–3.94) increased the risk of SPC among patients with laryngeal cancer. Additionally, women were at higher risk of SPC, in HNC overall group (HR = 1.68; 95% CI: 1.13–2.51) and oropharyngeal cancer group (HR = 1.74; 95% CI: 1.02–2.98). Tumour stage and male gender (larynx only) were positive predictors of cancer recurrence in HNC patients. Predictors of SPC were advanced age and alcohol use among laryngeal cancer cases, and female gender for oropharyngeal and HNC overall.

Original languageEnglish
Pages (from-to)1-14
Number of pages14
JournalEuropean Journal of Epidemiology
DOIs
Publication statusAccepted/In press - May 19 2018

Keywords

  • Head and neck cancer
  • Predictors
  • Preventive
  • Recurrence
  • Second primary cancer

ASJC Scopus subject areas

  • Epidemiology

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