Erken Evre ve Lokal İleri Evre Baş Boyun Kanserlerinde Hastalık Prognozunu Belirleyen Klinikopatolojik Faktörler
Pat Altıok, Hilal
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Head and neck cancers are the seventh most common cancer all over the world, and due to its morbidity and mortality burden it is an important health care issue. The aim of this study is to evaluate the prognostic effects of patient, tumor, and treatment-related factors over clinicopathological response. Between January 1, 2015 and January 1, 2021, 296 patients with early and locally advanced non-nasopharyngeal squamous cell cancer followed in Hacettepe Medical Oncology Department outpatient clinic who are older than 18 years of age and without recurrent/metastatic disease were included in the study. The median age at diagnosis was 58, of which 229 were male (77.4%) and 67 (22.6%) were female. While the most common tumor localizations in both sexes were found to be laryngeal, oral cavity and hypopharyngeal carcinomas with decreasing frequency; the most common localizations in women are oral cavity, oropharynx and hypopharynx, respectively. The most common localizations in men were larynx, oral cavity and hypopharynx, respectively. Median follow-up was 25 months. While the median overall survival of the patients was 45 months, the median disease-free survival was evaluated as 34 months. The 3-year overall survival rate of the patients was 57.7%, and the 3-year disease-free survival rate was 39.6%. In univariate analysis; being diagnosed over the age of 65 (p=0.017), having an ECOG performance score between 1 and 4 (p<0.001), advanced T stage (p=0.002), advanced N stage (p=0.010), in the group taking induction chemoradiotheraphy being in the group receiving docetaxel-carboplatin-cisplatin (p=0.019) or carboplatin-cisplatin (p=0.020) and being followed up with cetuximab chemoradiotheraphy in the group followed by (p=0.001) were associated with poor prognosis. In multivariate analysis it was shown that an ECOG performance score between 1 and 4 has a 2.817-fold risk of death compared with ECOG performance score 0 (HR: 2.817 95% CI: 1.707-4.647). T4 disease has a 2,07-fold risk of death when compared with T1-T2 disease (HR: 2.07 95% CI: 0.956-4.557) extracapsular extension has a 10,303-fold risk of death (HR: 10,303 95% CI: 2,584-41,071) and N3 disease increased the risk of death 54,104 times compared to N0 disease (HR: 54,104 95% CI: 4,901-597,273).