Erickson Bree, Biron Vincent L, Zhang Han, Seikaly Hadi, Côté David W J
Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Alberta, 1E4 Walter C Mackenzie Centre 8440-112 Street NW, Edmonton, AB, T6G 2B7, Canada.
Department of Otolaryngology-Head and Neck Surgery, University of California Davis, Sacramento, California, USA.
J Otolaryngol Head Neck Surg. 2015 Feb 3;44(1):4. doi: 10.1186/s40463-015-0056-8.
Oral cavity squamous cell carcinoma (OCSCC) is the most common head and neck cancer, affecting approximately 2000 Canadians yearly. Analysis of Canadian Cancer Registry data has shown that the incidence of oral cavity cancer is decreasing and survival outcomes are improving. There are significant health disparities in First Nations (FN) people in Canada. The incidence of cancer in FN groups is significantly lower when compared to the general population, but the cancer-related morbidity and mortality is significantly higher. There is no Canadian literature currently for OCSCC, or any other head and neck cancer, that compares survival outcomes of FN to the overall population. Therefore, the objective of this study is to determine whether there is a difference in epidemiology and survival outcomes between FN and non-FN patients with OCSCC.
This is a retrospective study of a population-based, prospectively-collected database from Alberta Cancer Registry (ACR). Patients with OCSCC, diagnosed and treated in Alberta between 1998 and 2009 were included. ACR data collected included patient gender, age at diagnosis, tobacco and alcohol use, FN status, TNM staging, performance status, date of death, cause of death, and follow-up. FN status was identified through the Alberta Health and Wellness registry and through postal code correlation for those who live on reserves.
A total of 583 patients with OCSCC were included in this study. Of these, 19 were identified as being FN, leaving 564 non-FN patients. When comparing the FN and non-FN groups, there is no significant difference in baseline demographics. Estimated yearly incidences for OCSCC in the Alberta population (all ages) and FN patients are 1.74/100,000 and 1.32/100,000 respectively (p = 0.23). Significant differences are seen in overall survival (OS) (5-year OS 58.1% for non-FN and 33.7% for FN) and for disease-specific survival (DSS) (5-year DSS 67.8% for non-FN and 44.5% for FN). Multivariate analysis confirmed FN patients have a significant increase risk of death in OS and DSS, with hazard ratios of 4.20 (p = 0.01) and 4.57 (p = 0.02), respectively.
The overall survival and disease specific survival are significantly lower in FN patients compared to non-FN patients with OCSCC.
口腔鳞状细胞癌（OCSCC）是最常见的头颈癌，每年约影响2000名加拿大人。对加拿大癌症登记数据的分析表明，口腔癌的发病率正在下降，生存结果正在改善。加拿大原住民（FN）人群存在显著的健康差异。与普通人群相比，FN群体中的癌症发病率显著较低，但与癌症相关的发病率和死亡率显著较高。目前尚无加拿大文献对OCSCC或任何其他头颈癌中FN与总体人群的生存结果进行比较。因此，本研究的目的是确定FN和非FN的OCSCC患者在流行病学和生存结果方面是否存在差异。
这是一项基于艾伯塔癌症登记处（ACR）前瞻性收集的基于人群的数据库的回顾性研究。纳入了1998年至2009年在艾伯塔省诊断和治疗的OCSCC患者。收集的ACR数据包括患者性别、诊断时年龄、烟草和酒精使用情况、FN状态、TNM分期、体能状态、死亡日期、死亡原因和随访情况。通过艾伯塔省健康与福利登记处以及通过居住在保留地的人的邮政编码相关性来确定FN状态。
本研究共纳入583例OCSCC患者。其中，19例被确定为FN，其余564例为非FN患者。比较FN组和非FN组时，基线人口统计学特征无显著差异。艾伯塔省人群（所有年龄段）和FN患者中OCSCC的估计年发病率分别为1.74/10万和1.32/10万（p = 0.23）。在总生存期（OS）（非FN患者5年OS为58.1%，FN患者为33.7%）和疾病特异性生存期（DSS）（非FN患者5年DSS为67.8%，FN患者为4·5%）方面存在显著差异。多变量分析证实，FN患者在OS和DSS中的死亡风险显著增加，风险比分别为4.20（p = 0.01）和4.57（p = 0.02）。
与非FN的OCSCC患者相比，FN患者的总生存期和疾病特异性生存期显著更低。
