Head and neck mucosal squamous cell carcinoma: results of palliative management

OBJECTIVE: To document the outcome of patients deemed at initial diagnosis to be appropriate for palliative care. MATERIALS AND METHODS: Over a five-year period, all patients with head and neck mucosal squamous cell carcinoma (HNMSCC) were referred to one consultant surgeon, and data were collated retrospectively. RESULTS: Of 286 patients with HNMSCC, 60 (21 per cent) were deemed appropriate for palliative care at initial diagnosis. Their median survival was 154 days, with hypopharyngeal and oropharyngeal tumours forming a disproportional percentage of the initial diagnoses (p < 0.001). After initial assessment, 66 per cent of patients were discharged to their home, 17 per cent to hospice care and 17 per cent were transferred to other institutions. Including deaths during the initial admission, 29 per cent of patients did not return home after diagnosis. Palliative treatment included operative interventions in 35 per cent and radiotherapy in 43 per cent. Time spent in further hospital care averaged 47 days, and 47 per cent of patients eventually died in hospital. CONCLUSION: One in five patients presenting with HNMSCC were deemed appropriate for palliative care at initial presentation and survived less than six months after diagnosis. More than one-third required surgical intervention, and 29 per cent never returned home.