Abrahão Renata, Perdomo Sandra, Pinto Luis Felipe Ribeiro, Nascimento de Carvalho Flávia, Dias Fernando Luis, de Podestá José Roberto V, Ventorin von Zeidler Sandra, Marinho de Abreu Priscila, Vilensky Marta, Giglio Raul Eduardo, Oliveira José Carlos, Mineiro Matinair Siqueira, Kowalski Luiz P, Ikeda Mauro K, Cuello Mauricio, Munyo Andres, Rodríguez-Urrego Paula A, Hakim José Antonio, Suarez-Zamora David Alfonso, Cayol Federico, Figari Marcelo Fernando, Oliver Javier, Gaborieau Valerie, Keogh Ruth H, Brennan Paul, Curado Maria Paula
Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France.
Division of Hematology/Oncology and Center for Healthcare Policy Research, University of California, Davis, Sacramento, CA.
JCO Glob Oncol. 2020 Mar;6:486-499. doi: 10.1200/GO.20.00014.
Head and neck squamous cell carcinoma (HNSCC) incidence is high in South America, where recent data on survival are sparse. We investigated the main predictors of HNSCC survival in Brazil, Argentina, Uruguay, and Colombia.
Sociodemographic and lifestyle information was obtained from standardized interviews, and clinicopathologic data were extracted from medical records and pathologic reports. The Kaplan-Meier method and Cox regression were used for statistical analyses.
Of 1,463 patients, 378 had a larynx cancer (LC), 78 hypopharynx cancer (HC), 599 oral cavity cancer (OC), and 408 oropharynx cancer (OPC). Most patients (55.5%) were diagnosed with stage IV disease, ranging from 47.6% for LC to 70.8% for OPC. Three-year survival rates were 56.0% for LC, 54.7% for OC, 48.0% for OPC, and 37.8% for HC. In multivariable models, patients with stage IV disease had approximately 7.6 (LC/HC), 11.7 (OC), and 3.5 (OPC) times higher mortality than patients with stage I disease. Current and former drinkers with LC or HC had approximately 2 times higher mortality than never-drinkers. In addition, older age at diagnosis was independently associated with worse survival for all sites. In a subset analysis of 198 patients with OPC with available human papillomavirus (HPV) type 16 data, those with HPV-unrelated OPC had a significantly worse 3-year survival compared with those with HPV-related OPC (44.6% 75.6%, respectively), corresponding to a 3.4 times higher mortality.
Late stage at diagnosis was the strongest predictor of lower HNSCC survival. Early cancer detection and reduction of harmful alcohol use are fundamental to decrease the high burden of HNSCC in South America.
南美洲头颈部鳞状细胞癌（HNSCC）发病率较高，而近期关于其生存率的数据较少。我们调查了巴西、阿根廷、乌拉圭和哥伦比亚HNSCC生存的主要预测因素。
通过标准化访谈获取社会人口统计学和生活方式信息，并从医疗记录和病理报告中提取临床病理数据。采用Kaplan-Meier法和Cox回归进行统计分析。
在1463例患者中，378例患有喉癌（LC），78例患有下咽癌（HC），599例患有口腔癌（OC），408例患有口咽癌（OPC）。大多数患者（55.5%）被诊断为IV期疾病，其中LC为47.6%，OPC为70.8%。LC的三年生存率为56.0%，OC为54.7%，OPC为48.0%，HC为37.8%。在多变量模型中，IV期疾病患者的死亡率比I期疾病患者高约7.6倍（LC/HC）、11.7倍（OC）和3.5倍（OPC）。目前和曾经饮酒的LC或HC患者的死亡率比从不饮酒者高约2倍。此外，诊断时年龄较大与所有部位的较差生存率独立相关。在对198例有可用人乳头瘤病毒16型（HPV）数据的OPC患者进行的亚组分析中，与HPV相关的OPC患者相比，HPV无关的OPC患者的三年生存率明显更差（分别为44.6%和75.6%），死亡率高3.4倍。
诊断时处于晚期是HNSCC生存率较低的最强预测因素。早期癌症检测和减少有害酒精使用对于降低南美洲HNSCC的高负担至关重要。
