The risk of recurrence in surgically treated head and neck squamous cell carcinomas: a conditional probability approach
Daniele Borsetto, Mantegh Sethi, Jerry Polesel, Michele Tomasoni, Alberto Deganello, Piero Nicolai, Paolo Bossi, Cristoforo Fabbris, Gabriele Molteni, Daniele Marchioni, Margherita Tofanelli, Fiordaliso Cragnolini, Giancarlo Tirelli, Andrea Ciorba, Stefano Pelucchi, Virginia Corazzi, Pietro Canzi, Marco Benazzo, Valentina Lupato, Vittorio Giacomarra, Diego Cazzador, Luigia Bandolin, Anna Menegaldo, Giacomo Spinato, Rupert Obholzer, Jonathan Fussey, Paolo Boscolo‐Rizzo
Abstract
BACKGROUND: Over 50% of patients with head-and-neck squamous cell carcinoma (HNSCC) experience locoregional recurrence, which is associated with poor outcome. In the course of follow-up for patients surviving primary surgery for HNSCC, one might ask: What is the probability of recurrence in one year considering that the cancer has not yet recurred to date? MATERIALS AND METHODS: To answer this question, 979 patients surgically treated for HNSCC (i.e. cancer of the oral cavity, oropharynx, hypopharynx or larynx) between March 2004 and June 2018 were enrolled in a multicenter retrospective cohort study, followed up for death and recurrence over a 5 year period. The conditional probability of recurrence in 12 months - i.e. the probability of recurrence in the next 12 months given that, to date, the patient has not recurred - was derived from the cumulative incidence function (Aalen-Johansen method). RESULTS: < 0.01), but not thereafter. This difference was most pronounced for oral cavity cancers. No significant differences were observed across different tumor sites. CONCLUSION: This dynamic evaluation of recurrence risk in patients surgically treated for HNSCC provides helpful and clinically meaningful information, which can be useful to patients in planning their future life, and to clinicians in tailoring post-treatment surveillance according to a more personalized risk stratification.