Survival and Recurrence Rate in Patients with Head and Neck Cancer and Associated Prognostic Factors

Head and Neck cancer (HNC) is the 6th most common cancer worldwide. Its recurrence probability is known as the greatest obstacle to prolong survival rate. This study was conducted to assess survival and recurrence rate of HNC and their associated risk factors. This retrospective cohort study was conducted on 179 HNC patients, who were diagnosed from April 2007 to November 2013 in Tehran, Iran. Two outcomes were simultaneously analyzed: time between diagnosis and disease recurrence or inter-recurrences; the time between diagnosis and death or end of the study. Kaplan-Meier curve, log-rank test, and general joint frailty model were utilized to data analysis, using Stata 11.0 and R. From 179 patients, 52.5% experienced relapse at least once and 15.6% of cases deceased. The survival rate in 12-, 24-, and 60- month were 94.4, 83.1%, and 55.4%, respectively. The median of survival time was 60.92 (1.1 - 72.9) months, which was longer in patients with relapse (63.62 versus 24.16). Advanced stage and the age older than 50 significantly increased the risk of death about 4-fold and 3-fold (P = 0.007, P = 0.014). Moreover, the initial treatment of surgery + radiotherapy + chemotherapy had significantly raised the hazard of relapse (P < 0.001). The percentage of deceased patients in relapse group was more than non-relapses, but the median of survival time in them was longer. Early detection can prevent recurrent events and the premature death of HNC patients.