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.