Study on the Epidemiological Characteristics, Treatment Patterns, and Factors Influencing the Timeliness of Treatment in Head and Neck Squamous Cell Carcinoma (HNSCC) in Stages III and IV: Experience of a Mexican Hospital

TL;DR

This study examines head and neck cancer cases in Mexico, focusing on treatment delays and patient outcomes.

Contribution

The study provides real-world data on HNSCC treatment patterns and delays in a Mexican hospital setting.

Findings

Most patients were male, with oral cavity and larynx as the most common tumor sites.

Median time from symptom onset to diagnosis was 166.5 days, and to treatment was 42 days.

Locoregional control was achieved in 42.8% of patients, with a low recurrence rate of 2.8%.

Abstract

Objective: In Mexico, head and neck cancers pose a significant health burden. GLOBOCAN reported approximately 3183 new cases and 1636 deaths in 2020. Despite being the sixth leading cause of cancer incidence and mortality worldwide, data on epidemiology and treatment patterns in Mexico remain limited. This study aimed to characterize the profile, clinical features, and management of patients with Stage III–IVB head and neck squamous cell carcinoma (HNSCC) in a real-world setting. Methods: We retrospectively analyzed a database of 187 patients with Stage III, IVA, or IVB HNSCC treated at the University Hospital Dr. José Eleuterio González. Demographics, disease characteristics, and treatment patterns were summarized as frequencies and percentages. Exploratory endpoints included clinical outcomes and recurrence types. Results: The cohort was 82.9% male (n = 155). The most frequent tumor sites were the oral cavity (36.9%) and larynx (36.9%), with 55% (n = 103) diagnosed at stage IVA. Of 75 cases tested for p16, 35.3% (n = 36) were positive. The median time from symptom onset to diagnosis was 166.5 days (95% CI: 123.4–197.8) and from diagnosis to treatment 42 days (95% CI: 31.6–50.4). Initial treatments included surgery (36.4%), chemoradiotherapy (24.6%), induction chemotherapy (19.8%), supportive care (11.2%), and radiotherapy (8%). Locoregional control was achieved in 42.8% of patients, with an overall recurrence rate of 2.8%. Conclusions: This study provides real-world insights into the epidemiology and management of locally advanced HNSCC in Mexico, outlining the patient journey from initial symptoms to treatment and underscoring the need for more individualized therapeutic strategies based on molecular profiling and clinical characteristics.

Figures