6th ICHNO Abstract Book

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page 18 6th ICHNO
6 th ICHNO Conference
International Conference on innovative approaches in Head and Neck Oncology
16 – 18 March 2017
Barcelona, Spain
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other primary cancer sites and Charlson comorbidities.
Death records from PMSI were compared to National
causes-of-death statistics (CEPIDC) using the same ICD-10
definitions. The mortality gap (PMSI minus CEPIDC) was
described overall and by sex, age category, region, H&N
cancer site, and year. We further explored the role of
primary cancer other than H&N cancer and Charlson
comorbidities other than cancer on misclassification bias
(i.e., a positive mortality gap) in multivariate Poisson
regression.
Results
Of 94,672 French patients identified with H&N cancer in
2008-2012, 41,503 patients with advanced H&N cancer
died at hospital. In comparison, 25,647 (61.8%) deaths
were attributed to H&N cancers in National causes-of-
death statistics during the same period. Misclassification
bias increased from 2008 to 2012 (+8% by year).
In multivariate Poisson regression, misclassification bias
was maximum in patients with oral cavity or oropharynx
cancer (except tongue), and misclassification bias was
higher in patients with hypopharynx cancer as compared
to laryngeal cancer. Misclassification bias significantly
increased in presence of another primary cancer recorded
before or at diagnosis of H&N cancer or distant metastasis.
Misclassification bias was not associated with severe
comorbidities other than cancer, but significantly
increased in patients receiving palliative care.
Correcting for mortality outside hospital would worsen the
mortality gap from 38.2% to 49.8%.
Conclusion
The study results suggest that the actual burden of H&N
cancer is underestimated by at least a third by French
National causes-of-death statistics.
Misclassification bias of the number of deaths attributable
to H&N cancer increased in the recent years.
PD-030 Survival of patients with head and neck cancers
in France (EPICORL study)
F. Huguet1, L. Geoffrois2, B. Le Vu3, Y. Pointreau4, M.
Bec5, C. Even6, L. Lévy-Bachelot5, S. Temam6, M.
Schwarzinger7
1Hôpital Tenon, Department of Radiotherapy, Paris
Cedex 20, France
2Institut de Cancérologie de Lorraine - Alexis Vautrin,
Medical Oncology, Vandoeuvre Les Nancy, France
3UNICANCER Fédération Nationale des Centres de Lutte
Contre le Cancer, Stratégie et Gestion Hospitalière,
Paris, France
4Centre Jean Bernard, Oncology, Le Mans, France
5MSD France, Market access, Courbevoie, France
6Institut Gustave Roussy, Head & Neck Surgical & Medical
Oncology, Villejuif, France
7THEN Translational Health Economics Network, Public
Health, Paris, France
Purpose or Objective
The aim of this study was to have an exhaustive
description of the recent epidemiology of head and neck
squamous cell carcinoma (H&N SCC) patients in France.
Material and Methods
We completed a retrospective cohort study using the
French National Hospital Discharge (PMSI) database. We
identified all adult patients residing in Metropolitan
France and diagnosed with H&N SCC (ICD-10: C00-C06;
C09-C14; C30.0; C31; C32) in 2008-2012. Cancer location
and stage (early I/II; locally advanced III/IVb; distant
metastatic IVc) were determined at diagnosis. Time to
relapse, secondary primary H&N cancer, other primary
cancers, Charlson comorbidities were recorded until last
hospital stay in 2013.
Hazard ratios (HR) for in-hospital death were estimated in
a multivariate Cox model with use of time-dependent
variables.
Results
131,965 French adults were identified with H&N SCC at
hospital in 2008-2012: 79.4% were male with median (IQR)
age of 61 (54-71) at diagnosis. Survival at 5 years was
34.0% (95% CI, 33.5%-34.4%) over a follow-up of 196,000
person-years. As compared to 23.2% patients with
laryngeal cancer, survival was significantly lower for 29.3%
patients with oral cavity cancer (HR=1.24), 19.5% patients
with oropharynx cancer (HR=1.22), or 12.8% patients with
hypopharynx cancer (HR=1.26). As compared to 30.7%
patients with early cancer at diagnosis, survival was
significantly lower for 57.2% patients with advanced
cancer (HR=1.65) and 12.1% patients with distant
metastasis (HR=6.19). Relapse rate at 3 years was 31.9% in
patients with early cancer and 51.8% in patients with
advanced cancer, with significantly lower survival
(HR=5.92). Secondary primary H&N cancers were detected
in 6.1% patients at diagnosis (HR=1.15) and 3.2% patients
at 3 years (HR=1.70). During the study period, about 31%
patients had another primary cancer (including 10.1%
lung) and about 52% patients had severe comorbidities
other than cancer incurring significantly lower survival.
Conclusion
This is the first national study on the epidemiology and
survival of patients with H&N SCC in France. Distant
metastasis at diagnosis and relapse in patients with early
or locally advanced cancer had the strongest impact on
prognosis. In addition, about two-third patients had
another primary cancer or severe comorbidities other than
cancer worsening prognosis over time.
PD-031 Quality of life, health status and work in head
and neck cancer survivors treated with radiotherapy
A. Matías-Pérez1, B. G. Díaz de Tudanca1, G. Gallego-
Herreros 1, M. Sánchez-Barba2, P. Soria-Carreras1, A.
Nieto-Palacios1, A. Rodríguez-Gutierrez1, L.A. Pérez-
Romasanta1
1Hospital Universitario de Salamanca, Radiation
Oncology Department, Salamanca, Spain
2Universidad de Salamanca, Statistics Department,
Salamanca, Spain
Purpose or Objective
Head and neck cancer (HNC) survivors are an increasing
population, due to the improvement in diagnosis and
treatment. The aim of this study is to analyse the quality
of life, health status, psychological status and work
activity in HNC survivors.
Material and Methods
The population was composed of a series of 50 HNC
patients (>3 years post-diagnosis) treated in our institution
from 2006 to 2013, having no signs of cancer recurrence
to date. Quality of life was measured with EORTC QLQ-C30
and HN35. The health status items measured were:
nutritional assessment using the Malnutrition Universal
Screening Tool (MUST), cardiovascular risk (with the
HeartScore® tool), toxic habits (tobacco and alcohol by
the Alcohol Use Disorders Identification Test (AUDIT)) and
physical activity (with the Global Physical Activity
Questionnaire(GPAQ)). Psychological evaluation was
performed by the State-Trait Anxiety Inventory (STAI) and
the State-Trait Depression Inventory (STDI). Patients were
asked about their work status before and after cancer
treatment.
Results
The mean age was 64 years (range, 43-84 years) and 46
patients (92%) were male. The most frequent site of the
primary tumour was larynx (48%) and the main histology
squamous cell carcinoma (76%). 72% of patients had
advanced cancers (stages III and IV), whereas 26% had