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Titolo:
ALCOHOLISM - INDEPENDENT PREDICTOR OF SURVIVAL IN PATIENTS WITH HEAD AND NECK-CANCER
Autore:
DELEYIANNIS FWB; THOMAS DB; VAUGHAN TL; DAVIS S;
Indirizzi:
UNIV WASHINGTON,DEPT OTOLARYNGOL HEAD & NECK SURG,1959 NE PACIFIC ST,BOX 356515 SEATTLE WA 98195 FRED HUTCHINSON CANC RES CTR,DIV PUBL HLTH SCI SEATTLE WA 98104 UNIV WASHINGTON,DEPT EPIDEMIOL SEATTLE WA 98195
Titolo Testata:
Journal of the National Cancer Institute
fascicolo: 8, volume: 88, anno: 1996,
pagine: 542 - 549
Fonte:
ISI
Lingua:
ENG
Soggetto:
KILLER-CELL-ACTIVITY; MULTIMODALITY THERAPY; PERIPHERAL-BLOOD; CONSUMPTION; CIRRHOSIS; MORTALITY; LYMPHOCYTES; REGRESSION; ABSTINENCE; IMMUNITY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
52
Recensione:
Indirizzi per estratti:
Citazione:
F.W.B. Deleyiannis et al., "ALCOHOLISM - INDEPENDENT PREDICTOR OF SURVIVAL IN PATIENTS WITH HEAD AND NECK-CANCER", Journal of the National Cancer Institute, 88(8), 1996, pp. 542-549

Abstract

Background: Despite recognition of the high prevalence of alcoholism among patients with head and neck cancer, the prognostic importance ofalcoholism has not been evaluated adequately. Previous investigators have speculated that alcoholic patients may have a poorer prognosis than nonalcoholic because of more advanced stage of cancer, the immunosuppressive effects of alcohol, and an increased rate of death due to other alcohol-related diseases. Purpose: The goal of this population-based study was to identify the features of alcoholism that are associated with survival for patients with head and neck cancer and to develop an alcoholic severity staging system from a composite of the independent features of alcoholism. Methods: This prospective study included 649 patients who were diagnosed with cancer of the oral cavity, oropharynx, hypopharynx, or larynx during the period from September 1, 1983, through February 28, 1987, in a three-county area of western Washingtonstate that participates in the Surveillance, Epidemiology, and End Results Program of the U.S. National Cancer Institute. Details on lifetime alcohol consumption, treatment for alcoholism, abstinence from alcohol prior to the diagnosis of cancer, and alcohol-related health problems were ascertained through in-person interviews near the time of diagnosis. Patients were classified as either nonalcoholics or alcoholicsaccording to their responses to questions from the Michigan Alcoholism Screening Test. The measures of alcohol consumption and abuse that were found to be independently associated with 5-year survival by logistic regression analysis were combined using conjunctive con patients solidation to create a final composite variable, called an alcoholic severity stage. Cox proportional hazards regression analysis was done toestimate the relative risk (RR) of death within 5 years due to specific causes of death for each of the alcoholic severity stages. Results:Alcoholism (RR = 2.06; 95% confidence interval [CI] = 1.43-2.98) and a history of alcohol-related systemic health problems (i.e., liver disease, pancreatitis, delirium tremens, or seizures) (RR = 2.76; 95% CI = 1.69-4.49) were associated with an increased risk of death, whereas abstinence (i.e., the consumption of fewer than one drink per week at 1 year prior to the diagnosis of cancer) (RR = 0.62; 95% CI = 0.39-0.97) was associated with a decreased risk of death. These associations were independent of age, site of cancer, anatomical stage, histopathologic grade, smoking, and type of antineoplastic treatment. Patients in the two worst alcoholic severity stages had an increased risk of dyingnot only of head and neck cancer but also of cardiovascular disease, pulmonary disease, and other alcohol-related causes. Conclusions: Alcohol abuse, measured by alcohol consumption, functional impairment, a history of alcohol-related health problems, or abstinence, can provide important prognostic information for patients with head and neck cancer. Our results suggest that sobriety among alcoholic patients can leadto prolonged survival.

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Documento generato il 24/10/20 alle ore 10:53:42