Emanuele Leoncini1, Vladimir Vukovic2, Gabriella Cadoni3, Roberta Pastorino2, Dario Arzani2, Cristina Bosetti4, Cristina Canova5, Werner Garavello6, Carlo La Vecchia7, Milena Maule8, Livia Petrelli3, Enrico Pira9, Jerry Polesel10, Lorenzo Richiardi8, Diego Serraino10, Lorenzo Simonato5, Walter Ricciardi2, Stefania Boccia11. 1. Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, L.go F. Vito, 1, Rome 00168, Italy; IRCCS San Raffaele Pisana, Via della Pisana, 235, 00163 Rome, Italy. 2. Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, L.go F. Vito, 1, Rome 00168, Italy. 3. Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, L.go F. Vito, 1, Rome 00168, Italy. 4. IRCCS, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Via La Masa 19, 20156 Milan, Italy. 5. Laboratory of Public Health and Population Studies, Department of Molecular Medicine, Via Loredan 18, 35131 Padua, Italy. 6. Clinica Otorinolaringoiatrica, Department of Surgery and Translational Medicine, Università degli Studi di Milano Bicocca, Via Cadore 48, 20053 Milan, Italy. 7. Department of Clinical Sciences and Community Health, University of Milan, Via Venezian 1, 20133 Milan, Italy. 8. Department of Medical Sciences, University of Turin, Turin, Corso Dogliotti 14, 10126 Turin, Italy. 9. Department of Public Health and Paediatrics, University of Turin, Via Zuretti n. 29, 10126 Turin, Italy. 10. SOC Epidemiologia e Biostatistica, IRCCS Centro di Riferimento Oncologico, Via F. Gallini 2, 33081 Aviano, Italy. 11. Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, L.go F. Vito, 1, Rome 00168, Italy; IRCCS San Raffaele Pisana, Via della Pisana, 235, 00163 Rome, Italy. Electronic address: sboccia@rm.unicatt.it.
Abstract
BACKGROUND: The purpose of this study is to evaluate whether demographics, lifestyle habits, clinical data and alcohol dehydrogenase polymorphisms rs1229984 and rs1573496 associated with first primary head and neck (HNC) are associated with overall survival, recurrence, and second primary cancer (SPC). METHODS: We conducted a follow-up study in five centres including 801 cases. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for overall survival, recurrence and SPC. RESULTS: Five-years overall survival was 62% for HNC cases, 55% for oral cavity, 53% for oropharynx, 41% for hypopharynx, and 71% for larynx. Predictors of survival were older ages (HR=1.18 for 5 years increase; CI: 1.07-1.30), higher tumour stage (HR=4.16; CI: 2.49-6.96), and high alcohol consumption (HR=3.93; CI: 1.79-8.63). A combined therapy (HR=3.29; CI: 1.18-9.13) was associated with a worst prognosis for oral cavity cancer. The only predictor was higher tumour stage (HR=2.25; CI: 1.26-4.03) for recurrence, and duration of smoking (HR=1.91; CI: 1.00-3.68) for SPC. ADH1B rs1229984 polymorphism HRs for HNC and oesophageal cancer death and for alcohol related cancer death were 0.67 (95% CI: 0.42-1.08), and 0.64 (95% CI: 0.40-1.03), respectively. CONCLUSIONS: The survival expectation differs among HNC sites. Increasing age and stage, and high alcohol consumption were unfavourable predictors of HNC survival overall. Duration of tobacco consumption before the first primary tumour was a risk factor for SPC.
BACKGROUND: The purpose of this study is to evaluate whether demographics, lifestyle habits, clinical data and alcohol dehydrogenase polymorphisms rs1229984 and rs1573496 associated with first primary head and neck (HNC) are associated with overall survival, recurrence, and second primary cancer (SPC). METHODS: We conducted a follow-up study in five centres including 801 cases. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for overall survival, recurrence and SPC. RESULTS: Five-years overall survival was 62% for HNC cases, 55% for oral cavity, 53% for oropharynx, 41% for hypopharynx, and 71% for larynx. Predictors of survival were older ages (HR=1.18 for 5 years increase; CI: 1.07-1.30), higher tumour stage (HR=4.16; CI: 2.49-6.96), and high alcohol consumption (HR=3.93; CI: 1.79-8.63). A combined therapy (HR=3.29; CI: 1.18-9.13) was associated with a worst prognosis for oral cavity cancer. The only predictor was higher tumour stage (HR=2.25; CI: 1.26-4.03) for recurrence, and duration of smoking (HR=1.91; CI: 1.00-3.68) for SPC. ADH1Brs1229984 polymorphism HRs for HNC and oesophageal cancer death and for alcohol related cancer death were 0.67 (95% CI: 0.42-1.08), and 0.64 (95% CI: 0.40-1.03), respectively. CONCLUSIONS: The survival expectation differs among HNC sites. Increasing age and stage, and high alcohol consumption were unfavourable predictors of HNC survival overall. Duration of tobacco consumption before the first primary tumour was a risk factor for SPC.
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Authors: L Giraldi; E Leoncini; R Pastorino; V Wünsch-Filho; M de Carvalho; R Lopez; G Cadoni; D Arzani; L Petrelli; K Matsuo; C Bosetti; C La Vecchia; W Garavello; J Polesel; D Serraino; L Simonato; C Canova; L Richiardi; P Boffetta; M Hashibe; Y C A Lee; S Boccia Journal: Ann Oncol Date: 2017-11-01 Impact factor: 32.976