Head and neck cancers excluding thyroid carcinoma
Of 111 non-thyroid HNCs analyzed, 4 patients (3.60%) were pediatric;
the remainder were 30 years or older. All four pediatric patients were
under one year old at autopsy (three malignant teratomas and one
infantile fibrosarcoma). Most deaths at autopsy in this group occurred
in patients between 50 and 70 years old (57.94%) Figure 1 .
More specifically, 21.21% of these deaths occurs between 55 and 59
years of age. A comparison of yearly incidence rates revealed no
statistically significant temporal trends in the diagnoses of
non-thyroid HNCs from 2000 to 2017 (p=0.993). A summary of patients’
characteristics and tumor sites is shown in Table 1 . The most
common causes of death found at autopsy in this group was HNC-related
malignancy (51.40%), heart disease (14.95%), and accidents (5.61%)Figure 2 . Laryngeal cancer was the most common malignancy with
cancer-related death (27 cases) followed by oral cancers (10). In 17
patients with stage 1 and 2 non-thyroid HNC found at autopsy, 8
(47.06%) had HNC-related deaths; in 35 patients with stage 3 and 4
cancer, 21 (60.00%) had HNC-related deaths. Most patients (51.40%) had
a median income between $50,000 and $75,000. Fisher’s Exact Test did
not yield predictive risk factors for cancer-related death at autopsy:
site (larynx, nasopharynx, oral, hypopharynx) (p=0.733), age (p=0.757),
AJCC stage (p=0.552), median household income (p=0.235), tumor size
(p=0.059), and gender (p=0.617).
Overall, 54 (50.47%) patients had laryngeal cancers (10 supraglottic,
13 glottic, and 31 unspecified subsite). Of these, 37 (62.58%) were
squamous cell carcinoma, 1 (1.85%) was adeno-squamous carcinoma, and 16
(29.63%) were unspecified. Staging of laryngeal cancers was as follows:
12 stage 1, 4 stage 2, 5 stage 3, and 11 stage 4. The median tumor size
was 40mm. The TMN staging and their frequencies were as follows: T1/T2
(61.29%), T3/T4 (38.79%); nodal positivity (18.18%); M1 (3.13%). In
addition, 50% of these laryngeal carcinomas were listed as their
primary cause of death. Laryngeal carcinoma-related deaths were most
common between 50-70 years old (59.26%; 27.77% of the patients were
older than 70). Only tumors greater than 4cm in size were a
statistically significant risk factors for deaths related to laryngeal
cancer (p=0.039). Fisher’s Exact Test showed none of the following were
predictive risk factors associated with laryngeal cancer death: site
(glottic and supraglottic) (p=0.990), age (p=0.861), AJCC stage
(p=0.289), and median house income (p=0.931). Race and gender were not
included in the analysis; an overwhelming number of patients in the
dataset were white and male.