Treatment Outcome for Head and Neck Squamous Cell Carcinoma in a Developing Country: University Malaya Medical Centre, Malaysia from 2003-2010


Background: Head and neck cancer (HNC) is the eighth most common cancer as estimated from worldwidedata. The incidence of HNC in Peninsular Malaysia was reported as 8.5 per 100,000 population. This studywas aimed to determine the treatment outcomes for HNC patients treated in the Oncology Unit of UniversityMalaya Medical Centre (UMMC). Materials and
Methods: All newly diagnosed patients with squamous cellcarcinoma of head and neck (HNSCC) referred for treatment to the Oncology Unit at UMMC from 2003-2010were retrospectively analyzed. Treatment outcomes were 5-year overall survival (OS), cause specific survival(CSS), loco-regional control (LRC) and radiotherapy (RT) related side effects. Kaplan-Meier and log rankanalyses were used to determine survival outcomes, stratified according to American Joint Committee onCancer (AJCC) stage.
Results: A total of 130 cases were analysed. Most cases (81.5%) were at late stage (AJCCIII-IVB) at presentation. The 5-year OS for the whole study population was 34.4% with a median follow up of24 months. The 5-year OS according to AJCC stage was 100%, 48.2%, 41.4% and 22.0% for stage I, II, III andIVA-B, respectively. The 5-year overall CSS and LCR were 45.4% and 55.4%, respectively. Late effects of RTwere documented in 41.4% of patients. The most common late effect was xerostomia.
Conclusions: The treatmentoutcome of HNSCC at our centre is lagging behind those of developed nations. Efforts to increase the number ofpatients presenting in earlier stages, increase in the use of combined modality treatment, especially concurrentchemoradiotherapy and implementation of intensity modulated radiotherapy, may lead to better outcomes forour HNC patients.