Management of synchronous head and neck and lung cancer is almost difficult. The aim of this observational study was to describe the impact of the lung cancer on the management and prognosis of HNC.
Inclusion criteria were: consecutive patients diagnosed between January 2011 and December 2015 in 19 French centers with HNC and synchronous lung cancer (all stages). We describe: clinical characteristics, management and outcomes. Patient characteristics and treatment information was analyzed descriptively. Kaplan-Meier estimation was used to assess median overall survival.
The study included 132 patients: men: 83%; 63,7 years old, current smokers: 59,8%; performans status: 0 and 1 for 22% and 66% of the patients respectively; high rate of comorbidities: cardiovascular: 63%, COPD: 33%. Main histology for HNC was squamous: 98%, (in oral cavity: 24%, oropharyngeal: 26%, hypo-pharyngeal: 22% and laryngeal: 28%) T classification was T1, T2, T3 and T4 in 16%, 24%, 28% and 18% of cases respectively, and N classification was N0, N1, N2, N3, for 36%, 18%, 20% and 8% of cases respectively. The main treatment was surgery, 37,1%, and chemo-radiotherapy, 35,6%. The diagnosis of lung cancer impacts the HNC management in 38% of the cases. Median delay between HNC and first day treatment was 54 days. HNC progressive free survival rate was 68% at 2 years. Lung cancers were mostly localized (stages I: 46%, stages II: 10%), squamous: 39%, or adeno-carcinomas: 39%. Main treatments were surgery: 29%, mainly lobectomy, radiotherapy: 13%, radio-chemotherapy: 14% and chemotherapy alone: 35%. Seven patients didn’t receive active treatment. Median delay of treatment was 82,3 days. Lung cancer progressive free survival rate was 35% at 2 years. OS was 40% at 2 years, better for stage I - II lung cancers (55%).
Synchronous lung cancer at HNC diagnosis significantly impacts the management and outcomes of HNC. Specific recommendations and multidisciplinary approach should be elaborate to improve the management of these patients.
Clinical trial identification
Legal entity responsible for the study
Groupe Français de Pneumo-cancérologie
Boringer Pierre Fabre
All authors have declared no conflicts of interest.