ABSTRACT
OBJECTIVE: The purpose of this study is to characterize head and neck squamous cell carcinoma (HNSCC) in the Puerto Rican population. This is a follow-up to our initial published report on the first 134 patients. Specifically, demographic characteristics, stage at presentation, initial treatment given, and rate of recurrence were studied. METHODS: Relevant data was obtained from 445 histologically confirmed HNSCC cases identified through the University of Puerto Rico School of Medicine Otolaryngology Department Head and Neck Cancer Clinics between August 1993 and January 2003. Data collected after informed consent included demographic factors (sex, age, areas of residence, income); risk factors (occupation, alcohol intake, cigarette usage); and pathological variables (tumor location, histopathology, stage at presentation, current disease status, tumor recurrence). RESULTS: The average age at diagnosis was 64.0 years (range 18-98); 84.5 per cent of the patients were male, 16 per cent were females. The most frequent anatomical sites of the primary tumor were the larynx (36.4 per cent) and the oral cavity (29.9 per cent). The majority of patients (61.1 per cent) presented with advanced stage (III-IV) disease at the time of diagnosis and over half (55.5 per cent) had moderately-differentiated tumors. Most patients had less than 12 years of formal education (81.2 per cent). Prolonged use of tobacco and alcohol identified in 88.1 per cent and 79.8 per cent of patients, respectively. The most frequent therapeutic modality used was radiation therapy followed by the combination of radiation and surgery. Twenty five percent of the cases experienced a recurrence of disease during the follow-up period. CONCLUSIONS: These findings emphasize the need for early detection programs for HNSCC in Puerto Rican patients given the high rate of advanced-stage disease at time of diagnosis. The key role of heavy alcohol intake and tobacco use as risk factors in the development of HNSCC is once again highlighted.
Subject(s)
Humans , Male , Female , Middle Aged , Carcinoma, Squamous Cell/epidemiology , Head and Neck Neoplasms/epidemiology , Alcoholism/epidemiology , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/therapy , Demography , Follow-Up Studies , Incidence , Neoplasm Recurrence, Local , Mouth Neoplasms/epidemiology , Mouth Neoplasms/pathology , Mouth Neoplasms/therapy , Laryngeal Neoplasms/epidemiology , Laryngeal Neoplasms/pathology , Laryngeal Neoplasms/therapy , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/therapy , Puerto Rico/epidemiology , Risk Factors , Tobacco Use Disorder/epidemiologyABSTRACT
The Otolaryngology--Head and Neck Surgery training program of the University of Puerto Rico, Medical School, is enjoining a full accreditation by the Residency Review Committee of the Accreditation Council for Graduate Medical Education. Since its foundation 76 Otolaryngologist--Head Neck surgeons have graduated, the first class was in 1962 and the last in June 1998, ten of them moved to the mainland where they practice or teach in renown universities. Our program is five year's durations, and it includes one year of general surgery and four years of progressive education in the specialty. Experience in the surgical sciences will precede the otolaryngology--head and neck surgery education, two residents are accepted each year