Douglas CM, et al. - Herein, the authors investigated how the type and number of symptoms correlated with survival in head and neck cancer patients. The significance of patients’ presenting symptoms was underscored in this research. This, in turn, yielded valuable information in highlighting suitable “red flag” symptoms and subsequent treatment planning and prognosis.

Methods

• During this research, patients were followed-up for over 10 years from the Scottish Audit of Head and Neck Cancer; (national cohort of head and neck cancer patients in Scotland 1999-2001).
• Cohort was linked to national mortality data in September 2013.
• Experts then recorded the first, second and third presenting symptoms at diagnosis.
• The setting of this trial was the National prospective audit-Scotland.
• Researchers selected 1,589 patients, from the original cohort of 1,895, who had cancer arising from one of the four main subsites: Larynx, oropharynx, oral cavity and hypopharynx.
• Median survival in relation to patients’ presenting symptoms served as the main outcome measures.

Results

• The eligible candidates included 1,146 (72%) males and 443 (28%) females, mean age at diagnosis 64 years (13-95).
• A notable variation was reported in the survival in relation to the number of the patient's presenting symptoms.
• One symptom presented with a median survival of 5.3 years compared with 1.1 years for three symptoms.
• Candidates with weight loss had a median survival of 0.8 years, compared to 4.2 years if they did not (p < 0.001).
• A median survival of 5.9 years was noted in individuals who presented with hoarseness compared to 2.6 years without (p < 0.001).
• No substantial variation was discovered in the long term survival for patients who presented with an ulcer, compared to those that did not (p=0.105).