Changes in presentation and survival of head and neck carcinomas in Northeastern Italy, 1975–1998
Article first published online: 23 JUL 2002
Copyright © 2002 American Cancer Society
Volume 95, Issue 3, pages 540–552, 1 August 2002
How to Cite
Barzan, L., Talamini, R., Franchin, G., Vaccher, E., Politi, D., Minatel, E. and Gobitti, C. (2002), Changes in presentation and survival of head and neck carcinomas in Northeastern Italy, 1975–1998. Cancer, 95: 540–552. doi: 10.1002/cncr.10682
- Issue published online: 23 JUL 2002
- Article first published online: 23 JUL 2002
- Manuscript Accepted: 11 MAR 2002
- Manuscript Revised: 11 FEB 2002
- Manuscript Received: 13 NOV 2001
- Ministero della Sanità
- Italian Association for Cancer Research (AIRC)
- retrospective study;
- head and neck carcinomas;
- changes in presentation
During the last 20 years, survival rates of head and neck carcinoma patients in the United States and Europe have plateaued. To determine the factors that can reduce mortality rates, we examined changes in clinical presentation and survival rates across 24 years of treatment of head and neck carcinoma patients.
A retrospective study of patients with head and neck carcinoma was conducted from January 1, 1975, to December 31, 1998. We identified 2143 eligible patients with squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, and larynx. Changes in gender, clinical stage, and therapy were evaluated separately for each site of cancer across five consecutive periods. Probability of dying and overall survival rates were estimated. Odds ratios (ORs) and hazard ratios were calculated.
An increase in T1 versus T2 or higher stage carcinoma was more probable for the oral cavity and larynx (OR = 4.1 and 3.0, respectively) in the last versus the earliest period. An increase in radical treatments was more probable for carcinomas of the oral cavity, oropharynx, hypopharynx, and larynx (10.2, 34.8, 12.5, and 2.1-fold, respectively) in the last versus the earliest period. A decreasing trend of probability of dying from the first head and neck carcinoma during the 1970s versus the 1990s was found. The overall survival rates at 5 years was 32% in 1975–1978 versus 51% in 1989–1993.
In contrast with survival rates in the United States and Europe, our findings show a significant increase in overall survival rates during the last 20 years. This increase is attributable to changes in diagnostic-therapeutic approaches and to early consultation with a physician for symptoms arising in the head and neck region. Cancer 2002;95:540–52. © 2002 American Cancer Society.