Classification of Head and Neck Cancers among Yemenis (A Prospective Descriptive Hospital Based –Study)

Abstract

Objective: The main objective of this study is to study head and neck cancer among Yemenis to establish a reliable database, determine the common histopathological type, common site, and defined the relation of the type and size to the age and gender of patients. Material and Methods: This study design was a prospective descriptive hospital-based study, carried out atAl-Komori–Teaching Hospital in the Sana’aRepublic of Yemen (major referral center of oncology). The material of this study consisted of 633 patients with head and neck cancer referred for management at the department of oral and maxillofacial surgery and to the consultant unit of the head and neck surgery and who were diagnosed clinically, radiographically and histopathology as having head and neck cancer. A patient who presented with recurrent cancer, or who had previous treatment with radiation or chemotherapy were excluded. Datawerecollectedfrompatienthistory (using a questionnaire sheet), clinical examination of patients, radiograph examination and from the histopathology results of the biopsies. Data have entered the computer and analysis using Statistical Package for Social Science (SPSS) (version 24). Quantitative data were summarized using simple descriptive statistics of mean and standard deviation (SD). A Chi-square test was used to assess the association and the level of significance among categorical variables. A P-value of less than 0.05 is considered statistically significant. Results: During the study period, 633 cases of head and neck cancers were seen, 355 cases (55.9%) were males and 279 cases (44.1%) were females, male to female ratio was 1.3:1. The patient age was ranged from 3 to 95 years with a mean age of 59.05 years ±std=15.9 years. The majority of cases (94.9%) were carcinomas, followed by lymphoma 2.5% and sarcoma 1.4%. The less common types were malignant melanoma and malignant fibrous histiocytoma, accounting 0.9 %and 0.2% respectively. Squamous cell carcinoma was the most common type of head and neck carcinoma, accounting (72.9%). Of lymphoma, all cases were Burkitt's lymphoma. Osteosarcoma was the most common type of sarcoma, accounting 55.5% of all sarcoma. The most common affected sites were oral cavity and facial skin, accounting 66.0% and 21.8% respectively. The less affected sites were salivary glands, jawbones and maxillary sinus, accounting 4.4%, 4.1% and 3.6% respectively. Of the oral cavity, the gingiva was the most affected site, followed by the tongue, accounting (33.3%) and (31.0%). Naso-labial region, infra-orbital region were the most common affected sites of the facial skin, accounting (23.9%) and (18.8%) respectively. Basal cell carcinoma and squamous cell carcinoma were the most common types of accounting, 75.4% and 23.2% respectively. Conclusion: The present study demonstrated the distribution of the head and neck cancers among Yemenis, determine the common type, common site and the relationship between the type and site to the age and gender of patients. In Yemen as in all countries, head and neck cancers were remained the disease of elderly male patients with a male to female ratio of 1.3:1. Patient age was running from 3 to 95 years. The majority of patients (90.9 %) were over the age of 40 years. Carcinoma was the commonest type, followed by lymphoma and sarcoma, accounting, 94.9%, 2.5% and 1.4% respectively. The oral cavity (66.0%) was the most affected site, followed by the facial skin accounting 21.8 %. The less affected sites were salivary glands, jawbones and maxillary sinus, accounting 4.4%, 4.1% and 3.6%respectively.