Prognostic factors associated with the survival of oral and pharyngeal carcinoma in Taiwan.
BACKGROUND
In Taiwan, a distinct ethnic group variation in incidence and mortality rates has been suggested for most carcinomas. Our aim is to identify the role of prognostic factors associated with the survival of oral and pharyngeal carcinoma in Taiwan.


METHODS
Taiwan Cancer Registry records of 9039 subjects diagnosed with oral and pharyngeal carcinoma were analyzed. The population was divided into three ethnic groups by residence, which were Taiwanese aborigines, Hakka and Hokkien communities. Five-year survival rates were estimated by Kaplan-Meier methods. Ethnic curves differed significantly by log-rank test; therefore separate models for Taiwanese aborigines, Hakka and Hokkien were carried out. The Cox multivariate proportional hazards model was used to examine the role of prognostic factors on ethnic survival.


RESULTS
The five-year survival rates of oral and pharyngeal carcinoma were significantly poorer for Hokkien community (53.9%) and Taiwanese aborigines community (58.1%) compared with Hakka community (60.5%). The adjusted hazard ratio of Taiwanese aborigines versus Hakka was 1.07 (95%CI, 0.86-1.33) for oral and pharyngeal carcinoma mortality, and 1.16 (95%CI, 1.01-1.33) for Hokkien versus Hakka. Males had significantly poor prognosis than females. Subjects with tongue and/or mouth carcinoma presented the worst prognosis, whereas lip carcinoma had the best prognosis. Subjects with verrucous carcinoma had better survival than squamous cell carcinoma. Prognosis was the worst in elderly subjects, and subjects who underwent surgery had the highest survival rate.


CONCLUSIONS
Our study presented that predictive variables in oral and pharyngeal carcinoma survival have been: ethnic groups, period of diagnosis, gender, diagnostic age, anatomic site, morphologic type, and therapy.
Chen
Ping-Ho
PH
Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Kaohsiung, Taiwan. phchen@nhri.org.tw <phchen@nhri.org.tw>
Shieh
Tien-Yu
TY
Ho
Pei-Shan
PS
Tsai
Chi-Cheng
CC
Yang
Yi-Hsin
YH
Lin
Ying-Chu
YC
Ko
Min-Shan
MS
Tsai
Pei-Chien
PC
Chiang
Shang-Lun
SL
Tu
Hung-Pin
HP
Ko
Ying-Chin
YC
D000328:Adult; D000367:Age Factors; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000208:ethnology / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D018289:Carcinoma, Verrucous / Q000208:ethnology / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008048:Lip Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D010610:Pharyngeal Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D011159:Population Surveillance; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries / Q000706:statistics & numerical data; D012107:Research Design; D012111:Residence Characteristics; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D014062:Tongue Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000473:pathology / Q000601:surgery