Outcomes for Patients at Head and Neck Cancer Consultation

Abstract

Objective: Head and neck cancer outpatient departments have to deal with challenging, impairing, and highly lethal diseases. As the search for better treatments continues, we aimed to analyze the clinical outcomes of our patients and to identify factors that may affect short-term survival.

Method: We performed a retrospective cohort study concerning all patients referred to the head and neck consultation of a Portuguese cancer center (Lisbon’s Instituto Português Oncologia) during 2008. Clinical and demographic data were obtained from medical records of those patients, from their first appointment until December 2011.

Results: Four hundred forty-four patients were referred to our consultation over the study period. Most of them were men (87%) and the mean age was 60.4 years (range, 14-86 years). The most common cancers were laryngeal (37%) and oropharyngeal (23%), and the majority (58%) were advanced (stage IVa or higher). Sixty percent of our patients were treated with surgery and adjuvant radiotherapy. The average time elapsed between treatment and first appointment was 80 days (range, 2-275 days). The overall 2-year survival rate was 58% and the 2-year disease-specific survival rate was 64%. The overall recurrence rate was 25%, mostly at the primary site.

Conclusion: Most of our patients had advanced tumors at the time of referral. Despite the early beginning of treatment at our center, survival, locoregional control, and treatment options are compromised. Public health policies should be developed to improve public health education regarding head and neck cancer prevention and early referral.