1. Clinicopathological features and outcome of Head & Neck Cancer in Pakistan 1A Jamshed, 1R Hussain, 2S Jamshed, 1A A Syed, 1A Loya, 1M A Shah, 1U Majeed & 1S Hameed 1Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan. 2Aga Khan University Medical College, Karachi, Pakistan.
Results
DFS Oral cancer (radical treatment)
Introduction
Results
Head and Neck Cancer (HANC) is the 6th most common cancer world wide and ranks 3rd in South Asia.
Majority of patients present with locally advanced disease. Loco-regional failure and distant metastases are common in this group and survival remains dismal despite aggressive treatment.
A significant number of HANC patients are unsuitable for aggressive radical management due to very advanced loco-regional disease, medical co-morbidities, distant metastasis or combination of these factors and are treated with palliative regimens.
Mean age was 52 years (12 – 90 years).
Male : Female ratio was 65%:35%.
Smoking, betel chewing, naswar & alcohol use was seen in 31%, 15%, 16% and 2%.
Table 1. Distribution by site No %
Oral cavity
1096 45
Larynx
333 14
Hypopharynx
191 8
Nasopharynx
157
6.5
Nasal / PNS
148 6
Salivary Glands
134
5.5
Oropharynx 56 2
Orbits 40
Unknown Primary 19 1
Skin
216 9
Others 27
DFS Laryngeal cancer (radical treatment)
Discussion
DFS Hypopharynx cancer (radical treatment)
Objectives
Table 2. AJCC stage by site
Site (No)
I/II %
III/IV %
UK %
Oral Cavity 27 69 4
Larynx 39 57
Hypopharynx 8 76 16
Nasopharynx 3 97 -
Salivary glands 21 48 31
PNS 87 10
Oropharynx 6 91
Studies from Pakistan on HANC are sparse in the medical literature. We report on clinicopathological features and survival of HANC treated at Shaukat Khanum Memorial Hospital and Research Centre (SKMCH & RC).
DFS Nasopharynx (radical treatment)
Methods
Between November 2003 – October HANC cases were seen at SKMCH.
Demographic, risk factors, pathological and TNM staging, treatment and follow up data were obtained from the head and neck unit database.
Survival analyses were carried out through Kaplan Meier method. The log rank test was used to measure the significance
All deaths and losses to follow up were considered as events for overall OS and DFS. Data was evaluated in December 2009.
Table 3. Histological subtype %
Squamous cell 73
Mucoepidermoid 9
Adenoid cystic 8
Adenocarcinoma 6
Basal cell 2
Others
Conclusion
References
Oral cancer is the most common HANC in Pakistan
Oropharynx is an unusal site of disease in our population.
Over 70% of the patients present with advanced stage disease
Survival of radically treated patients in our institution is comparable with other reports
5 year DFS following radical treatment for oral cancer, larynx, hypopharynx and nasopharynx was 36%, 71%, 16% and 48% respectively.