Head and neck cancer cases and prognosti̇c factors on survi̇val

SUMMARY Aim: Our aim was to investigate the clinicopathological features and the prognostic factors affecting survival in patients with head and neck cancer followed and treated in our center. Methods: The demographic, clinical and the histopathological data of the patients who were admitted to Dicle University Medical Oncology Clinic between 2003 and 2012 with a diagnosis of head and neck cancer were examined using the medical records. Impact on survival parameters such as age, gender, tumor stage, tumor size, tumor location, tumor histology, tumor histological grade, Positron Emission Tomography (PET) Standard Uptake Values maximum (SUVmax), performance status, smoking, alcohol use, settlement location, education status were examined. Findings: The data from 198 patients were analyzed. The median age of the patients was 58 (13-94) years. The median survival for all patients was 16.6 months. ≤ 58 years, while the median survival 24.1 months, > 58 years on the median survival was 10.8 months. Age was found to be prognostic factors (p = <0.0001). There were 165 men (83%) and 33 women (17%).In male patients, the median survival 15.2 months, while median survival for women was 27.4 months. In male patients, survival was worse than in women. Gender of patients was found near to significant in terms of survival (p = 0.09). Our patients of 96 (48%) were admitted from the urban. The patient admitted from villages and towns, the median survival 10.9 months, patients admitted from provincial centers was the median survival 17.6 months. The patients admitted from villages and towns of survival were worse. Settlement location of patients was found near to significant in terms of survival (p = 0.057). Our patients of 56 (28%) were illiterate. Illiterates, while median survival of 15.5 months, the median survival literate and graduates was 17.6 months. Survival was worse than illiterates. Literacy was found to be prognostic factors (p = 0.037). Farming as a profession in our patients 35 (17.6%) was highest proportion with the person. Our patients, 121 ((75%) were smoke consumers. 118 patients (59%) was the Eastern Cooperative Oncology Group (ECOG) 1. ECOG score of 0 in patients with median survival of 24.1 months, ECOG score 1 in patients with median survival of 18.5 months, ECOG score 2 in patients with median survival of 11.3 months, ECOG score of 3 patients with median survival of 6.7 months, respectively. Performance status was found to be prognostic factors (p = 0.004). The most common malignancy in 108 patients (54%) of laryngeal cancer was found. Nasopharyngeal cancer, the median survival was 29.7 months, while the value of peak, in the nasal cavity and sinus cancer, the median survival was 6.2 months and the low value of localization. Localization of the tumor was found to be prognostic factors (p = 0.038). The most common stage, 119 patients (59.8% ) had locally advanced. In patients median tumor diameter was 3.5 cm (1-10cm). In patients with tumors ≤3.5 cm in diameter while median survival 18.2 months, tumor diameter > 3.5 cm in patients with median survival was 10.9 months. Tumor diameter was found to be prognostic factor (p = 0.039). The median survival was 29.7 months in patients with local stage, median survival in patients with locally advanced 16.2 months, while median survival of 10.9 months in patients with advanced disease was. Tumor stage was found to be prognostic factors (p = 0.004). Squamous cell carcinoma, 162 (81%) patients was the most common histopathological types. The median survival in patients with squamous cell histopathology 16.2 months compared with histopathology in patients with non-squamous cell carcinoma, the median survival was 17.2 months. Histopathology in terms of survival was not significant ( p = 0.444 ). The most frequently observed among patients with histological grade of 30 (40%) patients were grade II. İn patients with histopathological least differentiated median survival 17.2 months, in patients with middle differentiated, median survival 8.9 months, in patients well-differentiated median survival was 10.3 months. Histological grade in terms of survival was not significant ( p = 0.342). Positron Emission Tomography (PET ) Standard Uptake Values maximum (SUVmax) median value was 11 ( 3-58 ). SUVmax in patients with values ≤ 11, while median survival 46.1 months, patients with SUVmax value > 11 was 17.2 months median survival. Suvmax value was found to be prognostic factors (p = 0.019). Results: Age, gender, tumor size, tumor stage, tumor localization, SUVmax value, contact from rural areas, illiteracy and performance status in patients with head and neck cancer were identified as prognostic factors influencing survival. Unlike our study, the SUVmax values and education were identified as prognostic factors related to survival. Key words: Head and neck cancer, survival, prognosis