Importance: Despite advances in treatment over the last decades, recurrent head and neck cancer continues to have a poor prognosis. Prognostic accuracy may help in patient counseling. Objective: To explore whether symptoms and clinical variables can predict prognosis in the setting of recurrent head and neck cancer. Design, Setting, and Participants: In this retrospective cohort study, patients treated for head and neck cancer with curative intent at Siteman Cancer Center in St Louis, Missouri (a tertiary cancer center) between January 1, 2007, and December 31, 2014, were reviewed. The dates of data analysis were October 2016 to June 2017. Patients who developed a recurrent cancer were included, with 196 patients meeting inclusion criteria. Main Outcomes and Measures: Symptoms and clinical findings at presentation of recurrence were recorded. Sequential sequestration and conjunctive consolidation (2 multivariable techniques) were used to create a composite staging system to predict 1-year overall survival (OS). Results: Among 196 patients (mean [SD] age, 61 [11] years; 166 [84.7%] of white race/ethnicity; 76.5% male), 1-year OS was 58.2% (114 of 196 patients). Time to recurrence, symptom severity stage, and rTNM stage were consolidated into a 3-category Clinical Severity Staging System, with 1-year OS rates of 90.2% (95% CI, 82.7%-97.6%) for the 61 patients classified as A, 58.1% (95% CI, 47.7%-68.6%) for the 86 patients classified as B, and 18.4% (95% CI, 7.5%-29.2%) for the 49 patients classified as C. The discriminative power of the new composite staging was better than that of the American Joint Committee on Cancer classification (C = 0.79 vs C = 0.66). Conclusions and Relevance: These findings suggest that clinical variables are associated with anticipated outcomes in patients with recurrent head and neck cancer.
Importance: Despite advances in treatment over the last decades, recurrent head and neck cancer continues to have a poor prognosis. Prognostic accuracy may help in patient counseling. Objective: To explore whether symptoms and clinical variables can predict prognosis in the setting of recurrent head and neck cancer. Design, Setting, and Participants: In this retrospective cohort study, patients treated for head and neck cancer with curative intent at Siteman Cancer Center in St Louis, Missouri (a tertiary cancer center) between January 1, 2007, and December 31, 2014, were reviewed. The dates of data analysis were October 2016 to June 2017. Patients who developed a recurrent cancer were included, with 196 patients meeting inclusion criteria. Main Outcomes and Measures: Symptoms and clinical findings at presentation of recurrence were recorded. Sequential sequestration and conjunctive consolidation (2 multivariable techniques) were used to create a composite staging system to predict 1-year overall survival (OS). Results: Among 196 patients (mean [SD] age, 61 [11] years; 166 [84.7%] of white race/ethnicity; 76.5% male), 1-year OS was 58.2% (114 of 196 patients). Time to recurrence, symptom severity stage, and rTNM stage were consolidated into a 3-category Clinical Severity Staging System, with 1-year OS rates of 90.2% (95% CI, 82.7%-97.6%) for the 61 patients classified as A, 58.1% (95% CI, 47.7%-68.6%) for the 86 patients classified as B, and 18.4% (95% CI, 7.5%-29.2%) for the 49 patients classified as C. The discriminative power of the new composite staging was better than that of the American Joint Committee on Cancer classification (C = 0.79 vs C = 0.66). Conclusions and Relevance: These findings suggest that clinical variables are associated with anticipated outcomes in patients with recurrent head and neck cancer.
Authors: Shao Hui Huang; Bayardo Perez-Ordonez; Ilan Weinreb; Andrew Hope; Christine Massey; John N Waldron; John Kim; Andrew J Bayley; Bernard Cummings; B C John Cho; Jolie Ringash; Laura A Dawson; Lillian L Siu; Eric Chen; Jonathan Irish; Patrick Gullane; Angela Hui; Fei-Fei Liu; Xiaowei Shen; Wei Xu; Brian O'Sullivan Journal: Oral Oncol Date: 2012-08-20 Impact factor: 5.337
Authors: Megan E Daly; Quynh-Thu Le; Peter G Maxim; Billy W Loo; Michael J Kaplan; Nancy J Fischbein; Harlan Pinto; Daniel T Chang Journal: Int J Radiat Oncol Biol Phys Date: 2009-06-18 Impact factor: 7.038
Authors: Irene Göllnitz; Johanna Inhestern; Thomas G Wendt; Jens Buentzel; Dirk Esser; Daniel Böger; Andreas H Mueller; Jörn-Uwe Piesold; Stefan Schultze-Mosgau; Ekkehard Eigendorff; Peter Schlattmann; Orlando Guntinas-Lichius Journal: Cancer Med Date: 2016-10-11 Impact factor: 4.452