title: Trends in epidemiology and treatment and outcome for head and neck cancer: a population-based long-term analysis from 1996 to 2011 of the Thuringian cancer registry.
abstract: BACKGROUND
  The objective of this study was to examine patterns of care and survival in a population-based sample of patients with head neck cancer (HNC) who were treated in Thuringia, a federal state in Germany, between 1996 and 2011.
  
  
  METHODS
  Data of 6291 patients with primary HNC from the Thuringian cancer registry were used to evaluate for patient's characteristics, tumor stage, incidence, and trends in treatment and overall survival (OS).
  
  
  RESULTS
  The distribution between stages I-IV did not change significantly during the observation period. Crude incidences of HNC increased significantly between 1996 and 2011 from 13.77 to 20.39 (relative risk [RR]=1.34; 95% confidence interval [CI]=1.25-1.45). This increase was mainly driven by a significant increase of oropharynx cancer (from 3.29 to 5.85; RR=1.67; 95%CI=1.49-1.88) and cancer of the oral cavity (3.41-5.90; RR=1.5; 95%CI=1.33-1.69). The relative frequency of multimodal therapy increased (RR=1.42; 95%CI=1.3-1.55). The use of cetuximab increased (RR=473.32; 95%CI=51.57-4344.51). The 5-year and 10-year OS for the entire cohort was 49.1% and 34.1%, respectively. The multivariable analysis has proven that male gender, age ⩾60years, therapy without surgery, and TNM stage were independent significant negative risk factors for OS (all p<0.0001).
  
  
  CONCLUSIONS
  OS did not improve during the study period. Incidence of oral cancer is significantly increasing. Although modern treatment strategies have been included in routine HNC care over the time, outcome has not improved significantly.
authors.affiliation: Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.
authors.forename: Orlando
authors.initials: O
authors.lastname: Guntinas-Lichius
authors.affiliation: Department of Radiooncology, Jena University Hospital, Jena, Germany.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Wendt
authors.affiliation: Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Kornetzky
authors.affiliation: Department of Otorhinolaryngology, Suedharzkrankenhaus Nordhausen, Nordhausen, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Buentzel
authors.affiliation: Department of Otorhinolaryngology, Helios-Klinikum Erfurt, Erfurt, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Esser
authors.affiliation: Department of Otorhinolaryngology, SRH Zentralklinikum Suhl, Suhl, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Böger
authors.affiliation: Department of Otorhinolaryngology, SRH Wald-Klinikum Gera, Gera, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Müller
authors.affiliation: Department of Oromaxillofacial Surgery and Plastic Surgery, Jena University Hospital, Jena, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Schultze-Mosgau
authors.affiliation: Department of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Jena, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Schlattmann
authors.affiliation: University Tumor Center, Jena University Hospital, Jena, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Schmalenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000628:therapy; D000068818:Cetuximab; D003131:Combined Modality Therapy / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D015994:Incidence; D007822:Laryngeal Neoplasms / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology / Q000628:therapy; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology / Q000628:therapy; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068818:Cetuximab
keywords: Cancer registry; Elderly; Epidemiology; Head and neck neoplasm; Risk; Survival