Table 2.
Clinical outcomes and direct costs of HNSCC, by phase-of-care
| Characteristics of incident patients diagnosed with HNSCC in 2010–2012 (N=53,255) | Initial treatment | Follow-up care in patients initially treated at early or locally advanced stage | |||
|---|---|---|---|---|---|
| Early stage | Locally advanced stage | Distant metastasis | Relapse treatment | Continuing care (without relapse) | |
| All patients by phase-of-care, n (%) | 15,747 (29.6) | 32,723 (61.4) | 4,785 (9.0) | 13,375 (25.1) | 26,496 (49.8) |
| Gender, n (%) | |||||
| Men | 11,414 (72.5) | 26,296 (80.4) | 3,938 (82.3) | 10,883 (81.4) | 20,114 (75.9) |
| Women | 4,333 (27.5) | 6,427 (19.6) | 847 (17.7) | 2,492 (18.6) | 6,382 (24.1) |
| Age at HNSCC diagnosis, n (%) | |||||
| <65 years old | 7,762 (49.3) | 21,767 (66.5) | 2,978 (62.2) | 9,291 (69.5) | 16,253 (61.3) |
| 65+ years old | 7,985 (50.7) | 10,956 (33.5) | 1,807 (37.8) | 4,084 (30.5) | 10,243 (38.7) |
| HNSCC site at diagnosis, n (%) | |||||
| Nasal cavity / paranasal sinuses | 1,266 (8.0) | 1,303 (4.0) | 285 (6.0) | 612 (4.6) | 1,567 (5.9) |
| Nasopharynx | 389 (2.5) | 1,187 (3.6) | 205 (4.3) | 418 (3.1) | 859 (3.2) |
| Lip | 1,857 (11.8) | 257 (0.8) | 43 (0.9) | 151 (1.1) | 1,788 (6.8) |
| Oral cavity | 3,906 (19.9) | 6,372 (19.5) | 805 (16.8) | 2,895 (21.6) | 5,612 (21.2) |
| Oropharynx | 2,787 (10.5) | 11,079 (33.9) | 1,514 (31.6) | 4,351 (32.6) | 6,862 (25.9) |
| Hypopharynx | 1,411 (9.1) | 6,562 (20.0) | 1,075 (22.5) | 2,723 (20.4) | 3,709 (14.0) |
| Larynx | 4,131 (26.2) | 4,793 (14.6) | 668 (13.9) | 1,953 (14.6) | 5,557 (21.0) |
| Ill-defined HNSCC | – | 1,170 (3.6) | 190 (4.0) | 272 (2.0) | 542 (2.0) |
| Charlson Comorbidity Index, n (%) | |||||
| 0 | 8,231 (52.3) | 13,954 (42.6) | 1,143 (23.9) | 4,736 (35.4) | 13,614 (51.4) |
| 1 | 2,917 (18.5) | 5,966 (18.2) | 560 (11.7) | 2,643 (19.7) | 5,200 (19.6) |
| 2 | 1,971 (12.5) | 5,818 (17.8) | 1,210 (25.3) | 2,483 (18.6) | 3,180 (12.0) |
| ≥3 | 2,628 (16.7) | 6,985 (21.4) | 1,872 (39.1) | 3,513 (26.3) | 4,502 (17.0) |
| Clinical outcomes | |||||
| Follow-up, mean (SD) months | 5.6 (1.4) | 5.5 (1.4) | 9.4 (9.2) | 9.6 (8.7) | 16.6 (10.8) |
| Death rate over the follow-up, n (%) | 1,641 (10.4) | 5,298 (16.2) | 3,855 (80.6) | 6,551 (49.0) | 3,211 (12.1) |
| Relapse rate at 18 months, cumulative incidence (95% CI) | 13.4 (12.9–13.9) | 32.5 (32.0–33.0) | – | – | – |
| Direct costs per month, mean (SD) euros | 2,566 (3,156) | 6,263 (3,334) | 7,340 (2,635) | 5,320 (3,365) | 435 (1,236) |
Notes: Cumulative incidence functions of relapse during continuing care were estimated for patients initially treated at early or advanced stage, while taking into account the competing risk of death. Patients with distant metastasis at initial treatment had a high death rate and direct costs per month were computed to the end of follow-up rather than the first six months
Abbreviations: HNSCC, head and neck squamous cell carcinoma.