Prognostic factors in oropharyngeal squamous cell carcinoma in the state of São Paulo, Brazil: 10-year follow-up

• Published in: Brazilian journal of otorhinolaryngology Vol. 88; no. Suppl 4; pp. S124 - S132
• Main Authors: Lau, Fabio, Tamanini, Jonas Belchior, Gazmenga, Fabio Portella, Mercuri, Gustavo, Oliveira, Vanessa Carvalho de, Araújo Teixeira, Daniel Naves, Couto, Eduardo Vieira, Chone, Carlos Takahiro
• Format: Journal Article
• Language: English
• Published: Brazil Elsevier Editora Ltda 01-11-2022; Elsevier; Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial
• Subjects: Brazil - epidemiology; Carcinoma, Squamous Cell - epidemiology; Carcinoma, Squamous Cell - therapy; Head and Neck Neoplasms - pathology; Humans; Neoplasm Staging; Original; Oropharyngeal Neoplasms - epidemiology; Oropharyngeal Neoplasms - therapy; Oropharynx; OTORHINOLARYNGOLOGY; Prognosis; Retrospective Studies; Squamous cell carcinoma; Squamous Cell Carcinoma of Head and Neck - pathology; Survival; Brazil; Survival; Squamous cell carcinoma; Oropharynx
• ISSN: 1808-8694; 1808-8686; 1808-8686
• DOI: 10.1016/j.bjorl.2022.07.003

•Among patients with oropharyngeal squamous cell carcinoma, 86.3% had advanced-stage disease and 13.7% had early-stage disease at diagnosis.•Disease-free survival did not differ significantly between patients receiving medical and surgical treatment among patients with the same staging.•Patients receiving medical treatment had shorter overall survival in both early and advanced stages of the disease compared with those undergoing surgery.
To descriptively analyze the epidemiological data, clinical stage, and outcomes of oropharyngeal squamous cell carcinoma in the state of São Paulo, Brazil, and to estimate the influence of clinical stage and treatment type on overall and disease-free survival.
We retrospectively analyzed epidemiological data from the São Paulo Cancer Center Foundation database relative to patients with oropharyngeal squamous cell carcinoma diagnosed between 2004 and 2014 in the state of São Paulo. Univariate and multivariate Cox regression analyses were performed to assess factors associated with the outcomes. A forward stepwise selection procedure was used. Survival curves were estimated by the Kaplan-Meier method and compared by the Gehan-Breslow-Wilcoxon test.
A total of 8075 individuals with oropharyngeal squamous cell carcinoma were identified. Of these, 86.3% were diagnosed at an advanced stage and 13.7% at an early stage. Only 27.2% of patients were treated surgically, whereas 57.5% were treated medically. Patients undergoing surgery had longer overall survival than those receiving medical treatment in both early- and advanced-stage oropharyngeal squamous cell carcinoma. However, there was no significant difference in disease-free survival between surgical and medical treatment.
No significant difference in disease-free survival between medical and surgical treatment suggests similar complete remission rates with both approaches. Patients receiving medical treatment had shorter overall survival, which may be due to complications from chemotherapy and radiotherapy. However, we cannot confirm this relationship based on the data provided by the São Paulo Cancer Center Foundation. Prospective studies are warranted to assess whether the lower overall survival rate in patients receiving medical treatment is secondary to complications from chemotherapy and radiotherapy.
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