Assuntos
Margens de Excisão , Neoplasias Orofaríngeas , Procedimentos Cirúrgicos Robóticos , Humanos , Procedimentos Cirúrgicos Robóticos/métodos , Neoplasias Orofaríngeas/cirurgia , Neoplasias Orofaríngeas/mortalidade , Neoplasias Orofaríngeas/patologia , Cirurgia Endoscópica por Orifício Natural/métodos , Endoscopia/métodos , Taxa de Sobrevida , Masculino , FemininoRESUMO
2 weeks wait (2ww) referral was intended to improve cancer outcomes in the UK. However, a previous study found that 2ww failed to detect early stage head and neck cancer. There is no current study to examine the survival outcome of head and neck cancer patients diagnosed on 2ww and non-2ww pathways. The aim of this study is to compare the outcome of cancer patients diagnosed on these pathways. We performed a retrospective review of head and neck cancer patients diagnosed between 2009 and 2013 in the ENT Department at Mid-Yorkshire NHS Hospitals Trust. Gender, age, disease staging, treatment modalities, route of referrals along with survival data were documented. Survival analysis was performed for 2ww and non-2ww cancer patients. There were 4123 patients referred on 2ww during the study period. 147 patients were diagnosed with cancers on 2ww and 89 patients were diagnosed on non-2ww. There were no statistical differences in clinical staging (p = 0.416) and overall survival (p = 0.376) between 2ww and non-2ww patients. This study failed to demonstrate a better overall survival in head and neck cancer patients diagnosed on 2ww pathway within the ENT cohort. Current referral system needs to be refined to improve the survival outcome in head and neck cancer patients.
Assuntos
Neoplasias de Cabeça e Pescoço/cirurgia , Otolaringologia , Encaminhamento e Consulta , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento , Reino Unido , Adulto JovemRESUMO
BACKGROUND: The neutrophil/lymphocyte ratio (NLR) has been found to be predictive of survival outcome in a range of tumors. The purpose of this study was to investigate the prognostic value of pretreatment (NLR) in patients with laryngeal squamous cell carcinoma (SCC). METHODS: A retrospective analysis of 140 patients with laryngeal SCC treated between 2005 and 2010 in the Hull and East Yorkshire Hospitals NHS Trust was carried out. Patient records were evaluated and both pretreatment neutrophil and lymphocyte counts were documented together with survival data, sex, smoking status, nodal classification, and disease staging. RESULTS: An elevated NLR was significantly associated with advanced disease stage (eg, node-positive and tumors stage III and IV). In addition, a high NLR was significantly associated with poor overall survival (OS) but not disease-free survival (DFS) on multivariate analysis, with the greatest significance seen in patients with the highest NLR. CONCLUSION: Pretreatment NLR may serve as a useful prognostic marker in laryngeal SCC; however, a large prospective study is required to determine an optimal NLR cutoff value. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1903-E1908, 2016.
