Journal
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
Volume 41, Issue 6, Pages 1908-1917Publisher
WILEY
DOI: 10.1002/hed.25630
Keywords
head and neck cancer; survival; epidemiology; cohort; Scotland
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Funding
- British Association of Head and Neck Oncologists
- Scottish Executive Health Department
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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.
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