Prognostic Factors in Advanced Head and Neck Cancer Patients Undergoing Multimodality Therapy

A retrospective analysis was performed to investigate potential prognostic factors for complete remission to neoadjuvant chemotherapy and overall survival in patients with previously untreated stage III and stage IV head and neck cancer. Eighty consecutive patients were treated in one of two studies...

Full description

Saved in:
Bibliographic Details
Published in:Otolaryngology-head and neck surgery 1991-07, Vol.105 (1), p.62-73
Main Authors: Mick, Rosemarie, Vokes, Everett E., Weichselbaum, Ralph R., Panje, William R.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Carcinoma, Squamous Cell - drug therapy
Carcinoma, Squamous Cell - mortality
Carcinoma, Squamous Cell - pathology
Female
Head and Neck Neoplasms - drug therapy
Head and Neck Neoplasms - mortality
Head and Neck Neoplasms - pathology
Humans
Male
Middle Aged
Prognosis
Retrospective Studies
Survival Rate
Citations: Items that this one cites
Items that cite this one
Online Access:Request full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A retrospective analysis was performed to investigate potential prognostic factors for complete remission to neoadjuvant chemotherapy and overall survival in patients with previously untreated stage III and stage IV head and neck cancer. Eighty consecutive patients were treated in one of two studies investigating three or four courses of neoadjuvant chemotherapy. Before local therapy with surgery and/or radiotheapy, 29% attained a complete remission. No strong significant and independent predictor of complete remission was identified. Only nodal stage (N) was found moderately associated with complete remission (p = 0.06). Node-negative patients had higher remission rates. Less important predictors were tumor stage (T) and site of disease; nasopharyngeal patients had superior remission rates (56%). With a median followup of 45 months and estimated 3-year survival rate of 38% (median 23.7 months), individual factors predictive of survival included pretherapy weight loss, performance status, alcohol use, pretherapy serum albumin level, site of disease, and N stage. In multivariate testing weight loss was identified as the strongest independent predictor of survival (p < 0.0001) and surpassed other health status measures, such as performance status and serum albumin level. In addition, N stage (p = 0.019) and alcohol use (p = 0.017) were found to be predictive. A cross-classification by N stage and weight loss revealed risk groups with distinctly different prognoses, which may be useful for design and analysis in future trials.
ISSN:0194-5998
1097-6817
DOI:10.1177/019459989110500109