Oncological Outcomes for Primary Head and Neck Squamous Cell Carcinoma in the United Kingdom: Results From a National Cross‐Sectional Cohort Study

OBJECTIVES: To investigate overall survival outcomes from primary head and neck squamous cell carcinoma (HNSCC) in the UK. DESIGN: A retrospective national observational cohort study with consecutive participants. SETTING: UK-wide head and neck cancer centres. PARTICIPANTS: All patients with HNSCC who received a definitive treatment decision between 01/09/2021 and 30/11/2021. Subgroup analysis of patients was stratified by head and neck subsites. MAIN OUTCOME MEASURES: Two-year overall (OS), disease-free (DFS), disease-specific (DSS), and local-recurrence-free-survival (LRFS) from primary HNSCC. RESULTS: Data from 1488 patients was submitted by 50 centres, of which 1286 were primary HNSCC. Median age was 65.5 years (IQR 57-74), and 911 (71.0%) were male. The most common subsites were oropharynx (37.6%), oral cavity (28.3%), larynx (22.0%), and hypopharynx (6.8%). Treatment intent was curative in 79.9% of cases. Of treatment modalities, 529 (41.3%) underwent surgery, 874 (68.4%) underwent radiotherapy, and 391 (30.7%) underwent chemotherapy. Two-year OS, DFS, DSS and LRFS were 79.7%, 72.2%, 84.8%, and 75.1%, respectively. Two-year OS was 83.5%, 55.4%, 73.9% and 84.6% for laryngeal, hypopharyngeal, oral cavity and oropharyngeal subsites, respectively. On multivariate analysis, clinical T staging, age, ECOG performance status, and p16 status were independent prognostic factors for survival. CONCLUSION: UK survival variations according to disease subsite reflect larger studies. Broader data over larger periods will reveal whether long-term improvements in the diagnosis, biological understanding, and treatments of HNSCC have translated into improvements in UK survival outcomes.