Gatta G.,Evaluative Epidemiology |
Botta L.,Evaluative Epidemiology |
Sanchez M.J.,University of Granada |
Sanchez M.J.,CIBER ISCIII |
And 3 more authors.
European Journal of Cancer | Year: 2015
Background Head and neck (H&N) cancers are a heterogeneous group of malignancies, affecting various sites, with different prognoses. The aims of this study are to analyse survival for patients with H&N cancers in relation to tumour location, to assess the change in survival between European countries, and to investigate whether survival improved over time. Methods We analysed about 250,000 H&N cancer cases from 86 cancer registries (CRs). Relative survival (RS) was estimated by sex, age, country and stage. We described survival time trends over 1999-2007, using the period approach. Model based survival estimates of relative excess risks (RERs) of death were also provided by country, after adjusting for sex, age and sub-site. Results Five-year RS was the poorest for hypopharynx (25%) and the highest for larynx (59%). Outcome was significantly better in female than in male patients. In Europe, age-standardised 5-year survival remained stable from 1999-2001 to 2005-2007 for laryngeal cancer, while it increased for all the other H&N cancers. Five-year age-standardised RS was low in Eastern countries, 47% for larynx and 28% for all the other H&N cancers combined, and high in Ireland and the United Kingdom (UK), and Northern Europe (62% and 46%). Adjustment for sub-site narrowed the difference between countries. Fifty-four percent of patients was diagnosed at advanced stage (regional or metastatic). Five-year RS for localised cases ranged between 42% (hypopharynx) and 74% (larynx). Conclusions This study shows survival progresses during the study period. However, slightly more than half of patients were diagnosed with regional or metastatic disease at diagnosis. Early diagnosis and timely start of treatment are crucial to reduce the European gap to further improve H&N cancers outcome. © 2015 Elsevier Ltd.All rights reserved.
Mehanna H.,Coventry University |
Mehanna H.,NHS England |
Olaleye O.,Coventry University |
Licitra L.,Head and Neck Cancer Medical Oncology Unit
Current Opinion in Otolaryngology and Head and Neck Surgery | Year: 2012
PURPOSE OF REVIEW: There is currently strong evidence supporting human papilloma virus (HPV) causation in a distinct disease entity of oropharyngeal cancer (OPC), with an increasing incidence worldwide.This review aims to critically analyse whether a change in our management approaches to HPV-positive OPC is now required for this increasingly significant public health concern. RECENT FINDINGS: HPV-positive OPC appears to have increased worldwide. HPV status has a strong prognostic effect, and, in combination with smoking status, primary, and nodal stage, is useful in the risk stratification of OPC. HPV-positive OPC responds better to chemoradiotherapy, surgery, and postoperative chemoradiotherapy than HPV-negative tumours, with improved survival outcomes. There remain concerns regarding the efficacy of HPV detection assays in clinical practice. HPV-negative head and neck cancer still accounts for the largest subset of patients that we treat and carries poor survival outcomes. SUMMARY: It is currently not advisable to change management for either HPV-positive or HPV-negative OPC as there is a lack of high-quality evidence to support this. High-quality randomized controlled trials are required to assess the efficacy of the different treatment modalities currently available for both HPV-positive and HPV-negative OPC. © 2012 Lippincott Williams & Wilkins, Inc.
Granata R.,Head and Neck Cancer Medical Oncology Unit |
Miceli R.,Unit of Clinical Epidemiology and trial Organization |
Orlandi E.,Fondazione Istituto Nazionale Dei Tumori |
Perrone F.,Molecular Pathology Laboratory |
And 13 more authors.
Annals of Oncology | Year: 2012
Background: Tumor human papillomavirus (HPV) status strongly affects overall survival (OS) of oropharyngeal cancer (OPC) patients. Recently, three groups with different outcomes were identified based on HPV status, smoking history and tumor stage. Our objective was to validate this model using a single-institutional retrospective database. Patients and methods: Patients (n = 120) diagnosed with OPC at our institution, treated with concomitant cisplatin plus radiotherapy (RT) (n = 64), induction chemotherapy followed by concomitant chemoradiation (n = 39) or RT alone (n = 17), were stratified in three groups with respect to the risk of death (low 26, intermediate 46 and high 49 patients) according to tumor p16 expression as surrogate of HPV status, pack-years of tobacco smoking and nodal/tumor stage. Group-stratified Kaplan-Meier OS curves were estimated and compared using the log-rank test. Results: The 2-year OS estimates were 100%, 86% and 70%, respectively. The difference between the survival curves was statistically significant (P = 0.009). The Harrell's concordance index was 0.70. The calibration plot showed a good concordance between our results and those observed in the original study. Conclusions: This study validates the risk grouping previously identified. Risk-driven clinical decision making and trial designs will help in better defining the most appropriate treatment in OPC patients. © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
Strategies to promote translational research within the European Organisation for Research and Treatment of Cancer (EORTC) Head and Neck Cancer Group: A report from the Translational Research Subcommittee
Psyrri A.,National and Kapodistrian University of Athens |
Licitra L.,Head and Neck Cancer Medical Oncology Unit |
Lacombe D.,European Organisation for Research and Treatment of Cancer Headquarters |
Schuuring E.,University of Groningen |
And 5 more authors.
Annals of Oncology | Year: 2010
Head and neck squamous cell cancer (HNSCC) is the sixth leading cause of cancer-related deaths worldwide. These tumors are commonly diagnosed at advanced stages and mortality rates remain high. Even cured patients suffer the consequences of aggressive treatment that includes surgery, chemotherapy, and radiotherapy. In the past, in clinical trials, HNSCC was considered as a single disease entity. Advances in molecular biology with the development of genomic and proteomic approaches have demonstrated distinct prognostic HNSCC patient subsets beyond those defined by traditional clinical-pathological factors such as tumor subsite and stage [Cho W (ed). An Omics Perspective on Cancer Research. New York/Berlin: Springer 2010]. Validation of these biomarkers in large prospective clinical trials is required before their clinical implementation. To promote this research, the European Organisation for Research and Treatment of Cancer (EORTC) Head and Neck Cancer Program will develop the following strategies-(i) biobanking: prospective tissue collection from uniformly treated patients in the setting of clinical trials; (ii) a group of physicians, physician-scientists, and EORTC Headquarters staff devoted to patient-oriented head and neck cancer research; (iii) a collaboration between the basic scientists of the Translational Research Division interested in head and neck cancer research and the physicians of the Head and Neck Cancer Group; and (iv) funding through the EORTC Grant Program and the Network Core Institutions Consortium. In the present report, we summarize our strategic plans to promote head and neck cancer research within the EORTC framework. © The Author 2010. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
Bossi P.,Head and Neck Cancer Medical Oncology Unit |
Kornek G.,Medical University of Vienna |
Lanzetta G.,Istituto Neuromed |
Rozzi A.,Medical Oncology |
And 3 more authors.
Head and Neck | Year: 2013
Background: In patients with recurrent and/or metastatic head and neck squamous cell cancer (HNSCC), there are no data about an every-other-week cetuximab maintenance schedule after chemotherapy plus cetuximab as first-line treatment. Methods: We reviewed the safety and feasibility of every-other-week maintenance cetuximab administered at 3 different European centers. Results: Thirty-one patients with recurrent or metastatic HNSCC were treated from 2006 to 2010. Mean cetuximab dose intensity in the maintenance phase was 93%. The major toxicities reported during every-other-week maintenance cetuximab were skin rash (grade 3, 16%; grade 2, 23%), fatigue (grade 3, 3%; grade 2, 16%), diarrhea (grade 3, 7%; grade 2, 13%), hypomagnesemia (grade 4, 3%; grade 3, 3%; grade 2, 19%), and mucositis (grade 3, 3%; grade 2, 23%). Conclusions: Every-other-week maintenance cetuximab schedule was well tolerated and did not worsen toxicity that occurred during chemotherapy. In daily practice, this simplified schedule could improve compliance and possibly improve quality of life in patients with recurrent or metastatic HNSCC that showed no progression during first-line chemotherapy. © 2012 Wiley Periodicals, Inc.