Determinants of long-term survival in a population-based cohort study of patients with head and neck cancer from Scotland

Head Neck. 2019 Jun;41(6):1908-1917. doi: 10.1002/hed.25630. Epub 2019 Jan 8.

Abstract

Background: We investigated long-term survival from head and neck cancer (HNC) using different survival approaches.

Methods: Patients were followed-up from the Scottish Audit of Head and Neck Cancer. Overall survival and disease-specific survival were calculated using the Kaplan-Meier method. Net survival was calculated by the Pohar-Perme method. Mutually adjusted Cox proportional hazards models were used to determine the predictors of survival.

Results: A total of 1820 patients were included in the analyses. Overall survival at 12 years was 26.3% (24.3%, 28.3%). Disease-specific survival at 12 years was 56.9% (54.3%, 59.4%). Net survival at 12 years was 41.4% (37.6%, 45.1%).

Conclusion: Determinants associated with long-term survival included age, stage, treatment modality, WHO performance status, alcohol consumption, smoking behavior, and anatomical site. We recommend that net survival is used for long-term outcomes for HNC patients-it disentangles other causes of death, which are overestimated in overall survival and underestimated in disease-specific survival.

Keywords: Scotland; cohort; epidemiology; head and neck cancer; survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Cohort Studies
  • Female
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / therapy
  • Health Behavior
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Risk Factors
  • Scotland
  • Survival Analysis
  • Survival Rate