Results and prognostic f actors in patients with head and neck cancer

Ebru AKKAŞ ATASEVER, Saadettin KILIÇKAP, Nalan BABACAN AKGÜL, Birsen YÜCEL, Emine Elif ALTUNTAŞ

Abstract

Aim. Our aim was to investigate the clinicopathological features, the treatment outcome and theprognostic factors affecting survival in patients with head and neck cancer followed and treated inour center. Methods. The demographic, clinical and the histopathological data of the patients whowere admitted to our center between 2007 and 2010 with a diagnosis of head and neck cancer wereexamined using the medical records. Results. The data from 82 patients were analyzed. Therewere 72 men (88%) and 10 women (12%). The median age of the patients was 57 (20-80) years.The youngest patients had nasopharyngeal, parahypopharyngeal and paranasal sinus tumors. Themost commonly encountered malignancy was the laryngeal cancer, which was found in 37 patients(45%). Fifty-five patients (67%) were Eastern Cooperative Oncology Group 1. The most commongrade was the locally advanced stage with 51 patients (62%). At time of the diagnosis, 60 (75%)patients had anemia, 30 (60%) patients had an elevated C-reactive protein, and 72 (89%) patientshad weight loss. Squamous cell carcinoma, which was seen in 69 (84%) patients, was the mostcommon histological type. Seventeen (47%) patients had perineural invasion, 17 (47%) patientshad lymphovascular invasion, and 12 (32%) patients had extracapsular invasion. Among thepatients, the most common grade was grade II, which was found in 34 (42%) patients. The overall Sivas Numune Hastanesi,median survival was 34 months. The 2-year survival rate was 75% for the patients with early-stage(I-II) cancer and 51% for the patients with locally advanced (III-IVA and B) cancer, the mediansurvival was 10 months in the presence of metastatic disease. The presence of hypertensioncomorbidity, performance status, location and stage of the cancer, T and N stage, interruption ofradiation therapy, C-reactive protein levels, and anemia were the factors that determined survival.Conclusion. The presence of hypertension, performance status, location and stage of the cancer, Tand N stage, interruption of radiation therapy, C-reactive protein levels, and anemia wereidentified as prognostic factors affecting survival in patients with head and neck cancers.

Özet

Amaç. Merkezimizde takip ve tedavi edilen baş boyun kanseri hastalarında klinikopatolojiközelliklerin, tedavi sonuçlarının ve sağkalımı etkileyen prognostik faktörlerin incelenmesiamaçlanmıştır. Yöntem. 2007-2010 tarihleri arasında merkezimize başvuran ve baş boyun kanseritanısı ile izlenmekte olan hastalara ait demografik, klinik ve histopatolojik veriler hasta dosya vehastane kayıtları incelenerek elde edildi. Bulgular. Seksen iki hastaya ait veriler analiz edildi. 72erkek (%88) ve 10 kadın (%12) hasta mevcuttu. Hastaların ortanca yaşı 57 (20-80) idi. En gençhastalar nazofarenks, parahipofarenks ve paranazal sinüs tümörü olan hastalardı. En yaygınmalignensi 37 hastada (%45) bulunan larenks kanseri idi. Elli beş hasta (%67) Eastern CooperativeOncology Group 1 idi. En sık evre 51 hasta (%62) ile lokal ileri evre idi. Tanı anında 60 (%75)hastada anemi, 30 (%60) hastada C-reaktif protein yüksekliği, 72 (%89) hastada kilo kaybı tespitedildi. Yassı hücreli karsinom 69 (%84) hasta ile en sık izlenen histopatolojik tip idi. On yedi(%47) hastada perinöral invazyon, 17 (%47) hastada lenfovasküler invazyon, 12 (%32) hastadaekstrakapsüler invazyon tespit edildi. Hastalar arasında en sık izlenen grade 34 (%42) hasta ilegrade II idi. Tüm hastalar için ortanca sağkalım 34 aydı. İki yıllık genel sağkalım oranı erken evre(I-II) hastalarda %75, lokal ileri hastalarda (III-IVA ve B) %51 iken, metastatik hastalık varlığındaise ortanca sağkalım 10 ay idi. Eşlik eden hipertansiyon varlığı, performans durumu, kanserinlokalizasyonu ve evresi, T ve N evresi, radyoterapiye ara verilmesi, C-reaktif protein düzeyi veanemi sağkalımı belirleyen faktörler idi. Sonuç. Hipertansiyon varlığı, performans durumu,kanserin lokalizasyon ve evresi, T ve N evresi, radyoterapiye ara verilmesi, C-reaktif proteindüzeyi ve anemi baş boyun kanserli hastalarda sağkalımı etkileyen prognostik faktörler olarakbelirlendi.