Audit about first consultations on head and neck oncological surgery in Brazil

Abstract

Introduction: The establishment of high complexity centers in Oncology aims to guarantee faster access to a specialist. Objective: to evaluate the profile of the cases referenced to a head and neck oncology center. Methods: Retrospective cohort study, selecting first consultations for head and neck surgical oncology in a public service of a philanthropic institution, for 12 consecutive months. Clinical and demographical data were obtained, besides information about diagnosis, staging of malignant cases, treatment and outcomes. Results: From the308 cases included, 197 (63.9%) cases confirmed malignancy (62.0%) or had high suspicion for cancer (1.9%). The remaining 111 (36.0%) cases were confirmed benign diseases (53 - 17.2%) or cases with high suspicion of benignity (58 - 18.8%). Non-melanocytic skin cancer comprised most of the malignant cases (63.3%); non-cancerous thyroid pathologies were the majority of benign cases (45.9%). Most cases of skin and lip cancer presented with disease at early stages (86.8%), while most cases of cancer of the upper airway and digestive tract (UADT) and thyroid/ salivary glands were in advanced stages (75.6 and 71.4%, respectively). There were not deaths related to the disease in the first year of follow-up, apart from the UADT cancer group. Among these, the 12-month survival was 45.9%. Advanced staging, history of alcoholism and irresectability/inoperability were associated with poorer prognosis. Conclusion: Compared to other global centers, the observed rate of first oncological consultations was high. Among the cases of UADT cancer, history of alcoholism and more advanced clinical and pathological presentation were associated with lower survival.