The risk of recurrence in surgically treated head and neck squamous cell carcinomas: a conditional probability approach

Authors

  • Daniele Borsetto Department of ENT, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  • Mantegh Sethi Department of ENT, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  • Jerry Polesel Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
  • Michele Tomasoni Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Brescia, Italy
  • Alberto Deganello Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Brescia, Italy
  • Piero Nicolai Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Brescia, Italy
  • Paolo Bossi Department of Medical Oncology, Medical Oncology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
  • Cristoforo Fabbris Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Section of Ear Nose and Throat (ENT), University of Verona, Verona, Italy
  • Gabriele Molteni Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Section of Ear Nose and Throat (ENT), University of Verona, Verona, Italy
  • Daniele Marchioni Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Section of Ear Nose and Throat (ENT), University of Verona, Verona, Italy
  • Margherita Tofanelli Department of Medical Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
  • Fiordaliso Cragnolini Department of Medical Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
  • Giancarlo Tirelli Department of Medical Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
  • Andrea Ciorba ENT Department, University Hospital of Ferrara, Ferrara, Italy
  • Stefano Pelucchi ENT Department, University Hospital of Ferrara, Ferrara, Italy
  • Virginia Corazzi ENT Department, University Hospital of Ferrara, Ferrara, Italy
  • Pietro Canzi Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico ‘San Matteo’ Foundation, Pavia, Italy
  • Marco Benazzo Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico ‘San Matteo’ Foundation, Pavia, Italy
  • Valentina Lupato Unit of Otolaryngology, Azienda Ospedaliera ‘S. Maria degli Angeli’, Pordenone, Italy
  • Vittorio Giacomarra Unit of Otolaryngology, Azienda Ospedaliera ‘S. Maria degli Angeli’, Pordenone, Italy
  • Diego Cazzador Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy
  • Luigia Bandolin Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy
  • Anna Menegaldo Department of Neurosciences, Section of Otolaryngology, University of Padova, Treviso, Italy
  • Giacomo Spinato Department of Neurosciences, Section of Otolaryngology, University of Padova, Treviso, Italy
  • Rupert Obholzer Department of ENT, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  • Jonathan Fussey Department of ENT, New Cross Hospital, Wolverhampton, UK
  • Paolo Boscolo-Rizzo Department of Medical Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy; Department of Neurosciences, Section of Otolaryngology, University of Padova, Treviso, Italy

DOI:

https://doi.org/10.1080/0284186X.2021.1925343

Keywords:

Head and neck cancers, survival, recurrence, conditional probability, squamous cell carcinoma

Abstract

Background

Over 50% of patients with head-and-neck squamous cell carcinoma (HNSCC) experience locoregional recurrence, which is associated with poor outcome. In the course of follow-up for patients surviving primary surgery for HNSCC, one might ask: What is the probability of recurrence in one year considering that the cancer has not yet recurred to date?

Materials and methods

To answer this question, 979 patients surgically treated for HNSCC (i.e. cancer of the oral cavity, oropharynx, hypopharynx or larynx) between March 2004 and June 2018 were enrolled in a multicenter retrospective cohort study, followed up for death and recurrence over a 5 year period. The conditional probability of recurrence in 12 months – i.e. the probability of recurrence in the next 12 months given that, to date, the patient has not recurred – was derived from the cumulative incidence function (Aalen-Johansen method).

Results

Overall, the probability of recurrence was the highest during the first (17.3%) and the second years (9.6%) after surgery, declining thereafter to less than 5.0% a year thereafter. The probability of recurrence was significantly higher for stage III–IV HNSCCs than for stage I–II HNSCCs in the first year after surgery (20.4% versus 10.0%; p < 0.01), but not thereafter. This difference was most pronounced for oral cavity cancers. No significant differences were observed across different tumor sites.

Conclusion

This dynamic evaluation of recurrence risk in patients surgically treated for HNSCC provides helpful and clinically meaningful information, which can be useful to patients in planning their future life, and to clinicians in tailoring post-treatment surveillance according to a more personalized risk stratification.

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Published

2021-07-03

How to Cite

Borsetto, D., Sethi, M., Polesel, J., Tomasoni, M., Deganello, A., Nicolai, P., … Boscolo-Rizzo, P. (2021). The risk of recurrence in surgically treated head and neck squamous cell carcinomas: a conditional probability approach. Acta Oncologica, 60(7), 942–947. https://doi.org/10.1080/0284186X.2021.1925343

Issue

Vol. 60 No. 7 (2021): Acta Oncologica

Section

Articles