Survival of patients with head and neck cancer-a retrospective study: A case of the Dar es salaam Ocean Road Cancer Institute (ORCI)

Background; Worldwide Head and Neck cancer (HNC) is the 6th most frequent cancer, with an estimated world incidence of over 600,000 new cases per year and 300,000 deaths yearly. In Tanzania there is no population based (community wide) data are available to show the true magnitude and burden of the disease. Data from Ocean Road Cancer Institute show that HNC is the 5th most common malignancy. Tobacco has been implicated as a risk factor for Head and Neck tumour sites; other factor that has been associated with Head and Neck cancer includes Alcohol, Human Papilloma Virus, Epstein Barr virus and hereditary syndromes. Studies on survival of Head and Neck cancer patients from developed countries showed that Socio demographic factors, clinic pathologic factors and treatment modalities are associated with 3 and 5 year survival rates; however there is no information in Tanzania or at ORCI, the only centre for cancer treatment in Tanzania on survival and its associate factors. The knowledge of these factors for survival in HNC influences the public awareness on the modes of prevention as well as evidence based choice of therapy to be used in Tanzania. Broad Objective To determine the survival rate and factors associated with survival of Head and Neck cancer patients at ORCI between Jan 2009 to December 2011. Methods This was a Retrospective Descriptive study conducted at ORCI, the only centre for treatment of cancer in Tanzania. A total of 200 random selected files of the patients with diagnosis of Squamous Cell Carcinoma of Head and Neck treated between 1st January, 2009 to 31st December, 2011 were reviewed. A standardised Questionnaire was used to obtain Socio demographic characteristics, clinic pathologic characteristics and different treatment modalities that were used in the treatment of the patients. Results The majority of HNC patients studied were above 56 years 43%, of these males were 76.6%. The Overall survival was 59%, factors seen to be associated with survival in this study were Stage at diagnosis with (P value =0.003), Anatomical site of the tumour (P value =0.038) and Total amount of radiation dose given (P value = 0.043). Conclusion Early stages of Head and Neck disease, Anatomical sites of the disease and Standard high Radiation doses of >40Gy are associated with longer survival in patients with HNC. The effect of socio demographic characteristics on HNC survival should be considered in the future prospective studies