Squamous cell carcinoma of the head and neck (HNSCC)--multi-modality treatment and impact on survival

INTRODUCTION: Head and neck cancers remain one of the top twenty cancers in Singapore for the past decade. Squamous cell carcinoma (SCC) is the commonest histology. Our aim was to obtain local figures on treatment modalities and survival outcomes. METHODS:This is a ten-year retrospective study of all head and neck SCC (HNSCC) cases operated from 1988-1998 at the Department of General Surgery, Singapore General Hospital. RESULTS: We treated 242 patients with HNSCC. Median follow-up time was 31 months. Seventy percent of these patients presented with Stage III/IV disease. The 3 most commonly occurring sites of HNSCC are 79 (33%) tongue, 68 (28%) rest of oral cavity and 36 (15%) larynx. The majority of the patients underwent surgical resection with reconstruction and adjuvant radiotherapy. The recurrence-free survival at 2 and 5 years are 60% (95% CI) and 52% (95% CI). The overall survival at 2 and 5 years are 70% (95% CI) and 55% (95% CI). The overall survival for Stages I-IV at 2 years' follow-up were 97%, 83%, 66% and 60% respectively and at 5 years' follow-up, were 83%, 71%, 59% and 38% respectively. CONCLUSIONS: HNSCC treated in this department over the last decade have resulted in survival rates that are comparable with those reported from international cancer centres and an improvement over previous local experience.