Clinical and epidemiological characteristics of patients in the head and neck surgery department of a university hospital
Keywords:
Epidemiology, Head and neck neoplasms, Habits, Alcoholism, TobaccoAbstract
CONTEXT AND OBJECTIVES: Head and neck cancer is the fifth most common type of cancer worldwide. The objective of this study was to evaluate the clinical and epidemiological parameters in a head and neck surgery service. DESIGN AND SETTING: Cross-sectional study using patients’ records, developed in otolaryngology and head and neck department of a university hospital in the northwest of the state of São Paulo. METHODS: A total of 995 patients in the head and neck surgery service between January 2000 and May 2010 were evaluated. The variables analyzed included: age, gender, skin color, tobacco and alcohol consumption, primary site, staging and histological tumor type, treatment and number of deaths. RESULTS: The disease was more frequent among men (79.70%), smokers (75.15%) and alcohol abusers (58.25%). The most representative sites were oral cavity (29.65%) and larynx (24.12%) for the primary site; squamous cell carcinoma (84.92%) was the most frequent histological type, and surgery (29.04%) and radiotherapy (14.19%) were the most common treatments. CONCLUSION: The cancer that affects patients assisted by the head and neck surgery service occurs mainly men, smokers and alcohol abusers, and the oral cavity and larynx are the sites with the highest incidence. The high rate of patients with stages III and IV indicates late diagnosis by the treatment centers, which reflects the need for prevention education campaigns for early diagnosis of the disease.
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Pai SI, Westra WH. Molecular pathology of head and neck cancer: implications for diagnosis, prognosis, and treatment. Annu Rev Pathol. 2009;4:49-70.
Döbrossy L. Epidemiology of head and neck cancer: magnitude of the problem. Cancer Metastasis Rev. 2005;24(1):9-17.
Lee KJ. Essential otolaryngology: head & neck surgery. 8th ed. Connecticut: McGraw-Hill Companies; 2003.
Marcu LG, Yeoh E. A review of risk factors and genetic alterations in head and neck carcinogenesis and implications for current and future approaches to treatment. J Cancer Res Clin Oncol. 2009;135(10):1303-14.
Walker DM, Boey G, McDonald LA. The pathology of oral cancer. Pathology. 2003;35(5):376-83.
Marur S, Forastiere AA. Head and neck cancer: changing epidemiology, diagnosis, and treatment. Mayo Clin Proc. 2008;83(4):489-501.
Instituto Nacional do Câncer. Boca. Available from: http://www2. inca.gov.br/wps/wcm/connect/tiposdecancer/site/home/boca/ definicao. Accessed in 2012 (Feb 24).
Kanavos P. The rising burden of cancer in the developing world. Ann Oncol. 2006;17 Suppl 8:viii15-viii23.
Alvarenga L de M, Ruiz MT, Pavarino-Bertelli EC, et al. Epidemiologic evaluation of head and neck patients in a university hospital of Northwestern São Paulo State. Braz J Otorhinolaryngol. 2008;74(1):68-73.
Crozier E, Sumer BD. Head and neck cancer. Med Clin North Am. 2010;94(5):1031-46.
Gillison ML, D’Souza G, Westra W, et al. Distinct risk factor profiles for human papillomavirus type 16-positive and human papillomavirus type 16-negative head and neck cancers. J Natl Cancer Inst. 2008;100(6):407-20.
Hennessey PT, Westra WH, Califano JA. Human papillomavirus and head and neck squamous cell carcinoma: recent evidence and clinical implications. J Dent Res. 2009;88(4):300-6.
Boffetta P, Hashibe M. Alcohol and cancer. Lancet Oncol. 2006;7(2):149-56.
Pavia M, Pileggi C, Nobile CG, Angelillo IF. Association between fruit and vegetable consumption and oral cancer: a meta-analysis of observational studies. Am J Clin Nutr. 2006;83(5):1126-34.
Guha N, Boffetta P, Wünsch Filho V, et al. Oral health and risk of squamous cell carcinoma of the head and neck and esophagus: results of two multicentric case-control studies. Am J Epidemiol. 2007;166(10):1159-73.
Peters ES, Luckett BG, Applebaum KM, et al. Dairy products, leanness, and head and neck squamous cell carcinoma. Head Neck. 2008;30(9):1193-205.
Conway DI, McMahon AD, Smith K, et al. Components of socioeconomic risk associated with head and neck cancer: a population-based case-control study in Scotland. Br J Oral Maxillofac Surg. 2010;48(1):11-7.
Santos LC, Cangussu MC, Batista Ode M, Santos JP. Oral cancer: population sample of the state of Alagoas at a reference hospital. Braz J Otorhinolaryngol. 2009;75(4):524-9.
Dergham AP, Muraro CC, Ramos EA, Mesquita LAF, Collaço LM. Distribuição dos diagnósticos de lesões pré-neoplásicas e neoplásicas de pele no Hospital Universitário Evangélico de Curitiba [Distribution of diagnosis of neoplastic and preneoplastic skin lesions at Evangelical Hospital in Curitiba]. An Bras Dermatol. 2004;79(5):555-9.
Golbert L, Wajner SM, Rocha AP, Maia AL, Gross JL. Carcinoma diferenciado de tireóide: avaliação inicial e acompanhamento [Differentiated thyroid carcinoma: initial evaluation and follow-up]. Arq Bras Endocrinol Metabol. 2005;49(5):701-10.
Ahrendt SA, Chow JT, Yang SC, et al. Alcohol consumption and cigarette smoking increase the frequency of p53 mutations in non- small cell lung cancer. Cancer Res. 2000;60(12):3155-9.
Kjaerheim K, Gaard M, Andersen A. The role of alcohol, tobacco, and dietary factors in upper aerogastric tract cancer: a prospective study of 10,900 Norwegian men. Cancer Causes Control. 1998;9(1):99-108.
Sobin LH, Wittelind CH. TNM classification of malignant tumors. 6th ed. New York: Wiley; 2002.
Vilela LD, Allison PJ. An investigation of the role of sense of coherence in predicting survival among Brazilians with head and neck cancer. Oral Oncol. 2010;46(7):531-5.
Potash AE, Karnell LH, Christensen AJ, Vander Weg MW, Funk GF. Continued alcohol use in patients with head and neck cancer. Head Neck. 2010;32(7):905-12.
Galbiatti AL, Ruiz MT, Biselli-Chicote PM, etal. 5-Methyltetrahydrofolate- homocysteine methyltransferase gene polymorphism (MTR) and risk of head and neck cancer. Braz J Med Biol Res. 2010;43(5):445-50.
Zigon G, Berrino F, Gatta G, et al. Prognoses for head and neck cancers in Europe diagnosed in 1995-1999: a population-based study. Ann Oncol. 2011;22(1):165-74.
St Guily JL, Borget I, Vainchtock A, Rémy V, Takizawa C. Head and neck cancers in France: an analysis of the hospital medical information system (PMSI) database. Head Neck Oncol. 2010;2:22.
La Vecchia C, Lucchini F, Negri E, Levi F. Trends in oral cancer mortality in Europe. Oral Oncol. 2004;40(4):433-9.
Silver HJ, de Campos Graf Guimaraes C, Pedruzzi P, et al. Predictors of functional decline in locally advanced head and neck cancer patients from south Brazil. Head Neck. 2010;32(9):1217-25.
Shuman AG, Entezami P, Chernin AS, et al. Demographics and efficacy of head and neck cancer screening. Otolaryngol Head Neck Surg. 2010;143(3):353-60.
Hayat MJ, Howlader N, Reichman ME, Edwards BK. Cancer statistics, trends, and multiple primary cancer analyses from the Surveillance, Epidemiology, and End Results (SEER) Program. Oncologist. 2007;12(1):20-37.
Hashibe M, Boffetta P, Zaridze D, et al. Contribution of tobacco and alcohol to the high rates of squamous cell carcinoma of the supraglottis and glottis in Central Europe. Am J Epidemiol. 2007;165(7):814-20.
Lee YC, Boffetta P, Sturgis EM, et al. Involuntary smoking and head and neck cancer risk: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Cancer Epidemiol Biomarkers Prev. 2008;17(8):1974-81.
Conway DI, Petticrew M, Marlborough H, et al. Socioeconomic inequalities and oral cancer risk: a systematic review and meta- analysis of case-control studies. Int J Cancer. 2008;122(12):2811-9.
Argiris A, Karamouzis MV, Raben D, Ferris RL. Head and neck cancer. Lancet. 2008;371(9625):1695-709.
Rouxel A, Hejblum G, Bernier MO, et al. Prognostic factors associated with the survival of patients developing loco-regional recurrences of differentiated thyroid carcinomas. J Clin Endocrinol Metab. 2004;89(11):5362-8.
Rogers SN, Pabla R, McSorley A, et al. An assessment of deprivation as a factor in the delays in presentation, diagnosis and treatment in patients with oral and oropharyngeal squamous cell carcinoma. Oral Oncol. 2007;43(7):648-55.
Wünsch-Filho V. The epidemiology of oral and pharynx cancer in Brazil. Oral Oncol. 2002;38(8):737-46.
Carvalho AL, Ikeda MK, Magrin J, Kowalski LP. Trends of oral and oropharyngeal cancer survival over five decades in 3267 patients treated in a single institution. Oral Oncol. 2004;40(1):71-6.
Ferlito A, Shaha AR, Silver CE, Rinaldo A, Mondin V. Incidence and sites of distant metastases from head and neck cancer. ORL J Otorhinolaryngol Relat Spec. 2001;63(4):202-7.
Sartor SG, Eluf-Neto J, Travier N, et al. Riscos ocupacionais para o câncer de laringe: um estudo caso-controle [Occupational risks for laryngeal cancer: a case-control study]. Cad Saude Publica. 2007;23(6):1473-81.
Wünsch Filho V. The epidemiology of laryngeal cancer in Brazil. Sao Paulo Med J. 2004;122(5):188-94.
Ruiz MT, Pavarino-Bertelli E, Maniglia JV, Ruback MJC, Goloni-Bertollo EM. Epidemiologia e biomarcadores de em câncer de cabeça e pescoço [Head and neck cancer epidemiology and biomarkers]. Arq Ciênc Saúde. 2006;13(1):34-8.