The predictive factors of primary head and neck cancer stage at presentation and survival in a developing nation’s tertiary hospital

Abstract

Background: Stage of head and neck cancers at presentation is a strong determinant of outcomes. Objective: To evaluate predictors of stage of head and neck cancers at presentation and survival in a Nigerian tertiary hospital. Patients and methods: Health records that met the inclusion criteria for head and neck cancers were retrieved using the International Classification of Diseases, 10th revision and analyzed with associations between variables modeled using logistic regression analysis. Results: From a record of 487 head and neck neoplasms, 129 (26.5%) were malignant of which 122 health records met the criteria for analysis consisting of 83 (68.0%) males and 39 (32.0%) females aged 13–85 years (mean = 51 years; standard deviation = ±16 years). Alcohol (odds ratio = 1.99; 95% confidence interval = 1.08–3.69; p = 0.02) and tobacco exposure (odds ratio = 3.07; 95% confidence interval = 1.32–7.16; p = 0.01) were associated with increased odds for advanced tumor stage at presentation. Stage IV cancer (hazard ratio = 1.44; 95% confidence interval = 1.80–2.59), alcohol (hazard ratio = 2.19; 95% confidence interval = 1.18–4.10) and tobacco use (hazard ratio = 3.40; 95% confidence interval = 1.22–8.74) were associated with increased hazards for death. Conclusion: Alcohol, tobacco use and smoke from cooking wood are predictive factors for advanced HNC stage at presentation. Stage IV cancer, alcohol and tobacco use were associated with an increased hazard for death.