title: Pretreatment risk stratification for non-metastatic head and neck squamous cell carcinoma in a high-prevalence area.
abstract: BACKGROUND
  This retrospective study was to establish a prognostic scoring system for patients with non-metastatic head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  The medical records of 151 patients with HNSCC were evaluated. Clinical data were collected and statistical analyses were performed to determine the prognostic value of pretreatment variables and to build a risk stratification system. Analysis of the data for 94 additional patients validated the risk stratification system.
  
  
  RESULTS
  Three independent adverse prognostic factors were identified: Age <65 years, LDH ≥ upper normal limit and performance status. The risk stratification was defined as two or more adverse factors presented at diagnosis versus one adverse factor or no adverse factors. Patients with two or more adverse factors had a shorter survival regardless of treatment. This was confirmed in both the training set and the validation set.
  
  
  CONCLUSIONS
  This risk stratification provides additional information to the current tumor staging system, which could be useful in making decisions for individual patients and selecting more homogenous patients when designing clinical trials.
authors.affiliation: Division of Hematology and Oncology, Taipei Medical University-Shuan-Ho Hospital, New Taipei City, Taiwan, ROC.
authors.forename: Yao-Yu
authors.initials: YY
authors.lastname: Hsieh
authors.forename: Peter
authors.initials: P
authors.lastname: Mu-Hsin Chang
authors.forename: Ming-Huang
authors.initials: MH
authors.lastname: Chen
authors.forename: Pen-Yuan
authors.initials: PY
authors.lastname: Chu
authors.forename: Cheng-Hwai
authors.initials: CH
authors.lastname: Tzeng
authors.forename: Shyue-Yih
authors.initials: SY
authors.lastname: Chang
authors.forename: Po-Ming
authors.initials: PM
authors.lastname: Chen
authors.forename: Muh-Hwa
authors.initials: MH
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012306:Risk; D000077195:Squamous Cell Carcinoma of Head and Neck