Clinical characteristics of head and neck cancers at a tertiary care hospital

Abstract

INTRODUCTION Head and neck cancer (HNC) is common and accounts for thousands of deaths each year. In Saudi Arabia alone hundreds of cases and deaths due to head and neck cancers are reported owing to alarmingly high consumption of tobacco and infections such as Epstein-Barr virus (EBV) and human papillomavirus (HPV) that lead to metastatic or loco-regional or viral-associated HNC. Nasopharyngeal cancer (NPC) is most common among all HNCs in Saudi Arabia, with male predominance in having a poor survival rate. Comprehensive studies documenting extensive variables related to HNC are lacking in Saudi Arabia; hence, it is particularly important to document the clinical characteristics of this cancer, especially in the Saudi population. Therefore, the present study aimed to understand the clinical characteristics of patients with HNC treated at King Fahad Medical City (KFMC). METHODS A hospital-based retrospective cohort study included patients diagnosed with HNC from 2009–2018 as per the electronic medical records and treated at KFMC. All patients with histopathologically confirmed cancer at sites including oral cavity, nasopharynx, oropharynx, pharynx, larynx, sinonasal, and salivary glands were included. The endpoints were to assess tumour site of HNC, frequency of HNC based on histology, tumor-node-metastasis (TNM) staging, and etiological factors of HNC. The pattern of treatment failure was also recorded in reference to the site of tumour recurrence as local, general or distant. RESULTS Out of 1349 patients screened, 652 were confirmed with HNC. The most common primary tumor site was the oral cavity (25.9%), followed by nasopharynx (23.8%), and larynx (17.5%). Squamous cell carcinoma was the most common HNC (78.1%). Based on TNM staging, the frequency of HNC varied from stage 0 to 4, with 64.6% of patients in stage 4. Infection with Epstein-Barr virus (EBV) was found in 8.5% of patients. Treatment failures were recorded in 24.3% of patients, and 62.5% of patients reported metastasis. CONCLUSIONS High tobacco consumption in the region needs to be monitored and controlled by awareness and education campaigns. Effective management of HNC with early diagnosis and treatment is required by healthcare professionals to improve the overall quality of life of HNC patients.