Article
Recurrence and Survival in Resected Head and Neck Squamous Cell Carcinoma: 10-Year Results of a Randomized Clinical Trial
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Published: | March 20, 2006 |
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The following data was derived from a prospective, randomized, open, multi-center trial of patients with head and neck cancer. The trial evaluated adjuvant mistletoe treatment and demonstrated no beneficial effect in head and neck cancer patients (Eur J Cancer 2001; 37:23-31). Moreover, the follow up of this large collective of tumor patients showed the characteristics described here: The trial included 477 patients with head and neck cancer (stage grouping: I = 103, II = 95, III = 82, IV = 197; tumor location: oral cavity = 78, oropharynx = 136, hypopharynx = 78, larynx = 185), who underwent either surgery or surgery with radiotherapy (with or without mistletoe treatment). Tumors were resected by laser or conventionally. Radiation was utilized - in principle - when neck metastasis were found. The median follow up period after enrollment is 9,8 years for surviving patients, now. In 262 of the 477 (45,9%) patients, the following first events occurred: 71 (27,1%) local recurrences alone, 34 (13,0%) local/locoreginal recurrences, 22 (8,4%) lymph node metastases of the neck, 66 (25,1%) distant metastases, and 95 (36,3%) metachronous primaries. The follow up of the 208 patients that are still alive to date revealed that 10 (4,8%) patients had a local recurrence, 2 (1,0%) had a local and a locoregional recurrence, 6 (2,9%) had only cervical lymphnode metastasis, 3 (1,4%) had distant metastasis, and 29 (13,9%) had metachron secondary carcinoma. To date, 269 (56,4%) have died. Furthermore, no statistically significant difference was found in the disease free survival rate between laser and conventional resection (adjusted hazard ratio 1.008 [95% confidence interval from 0.711 to 1.434; p=0.391]). The disease specific survival has the same results.