Oropharynx squamous cell carcinoma in Madeira population from 2009-2019: A 5 year survival analysis and predictive factors of outcome
DOI:
https://doi.org/10.34631/sporl.1042Keywords:
Oropharynx squamous cell carcinoma, Staging, Survival rate, Surgical treatment, Adjuvant therapy, Medical treatment aloneAbstract
Introduction: Oropharynx squamous cell carcinoma (OP-SCC) had an annual global incidence of 98 412 and 48 143 deaths worldwide in 2020. The prognosis is variable and prognostic factors are important in selection of best treatment strategy for each patient.
Objective: The aim of this work was to perform a survival analysis and to investigate the impact of clinical factors on the prognosis of oropharyngeal squamous cell carcinoma (SCC) patients.
Material and methods: Retrospective study between 2009-2019 in a tertiary care center. Categorical data were analyzed using the exact chi-square test. The survival curves for each variable were estimated using the Kaplan-Meier method; The Cox regression model was applied to assess the effect of the clinical variables on survival (age, gender, tobacco and alcohol consumption, tumor location, prognostic stage group and type of treatment). Patients lost to follow-up or with palliative intent were excluded from the survival analysis(n=24). It was not possible to obtain HPV status.
Results: Data from 180 patients diagnosed with oropharyngeal squamous cell carcinomas (SCC) were analyzed.
The median age on presentation was 56,00±10,436 years and 91,9% of patients were male. The majority of patients (76,6%) reported tobacco and/or alcohol consumption. Most of the oropharyngeal SCC (88,4%) patients were diagnosed at advanced stages. 71,7% of cases were stage IV and 16,7% were stage III. The median follow-up time was 11,00 months (+/- 20,50).
In general, the only variables with a statistically significant impact on survival were tumor stage (p=0,018) and type of treatment (p<0,0001). Stage I patients had a 5-year OS rate of 56,3% while stage IV (IVa, IVb, IVc) patients had lower rates (30,6%). Regarding type of treatment, surgery alone had a 5-year overall survival rate of 46,7%, followed by surgery plus adjuvant radiotherapy (37,5%) and chemoradiotherapy (15,4%).
Amongst all the variables included in the Cox regression model, type of treatment was the only one with a significant effect on survival: patients that underwent medical treatment alone had a 1,85 times higher death risk (p=0,017).
Discussion and conclusion:
Prognostic stage groups and type of treatment were associated with an impact on outcome, regardless of other variates, following the trend in literature.
Furthermore, medical treatment alone was also associated with lower survival rates than surgery +/- adjuvant therapy.
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