Head and neck squamous cell carcinoma (HNSCC) in non-at risk patients: A case control study

Abstract

5583 Background: Most clinical, molecular and histological investigations of HNSCC concern patients who were at risk due to overexposure to tobacco and alcohol. The clinical pattern and the biological pathway involved in-patients lacking these risk factors may be quite different. The aim of this study was to provide clinical, molecular and histological information's about HNSCC in patients without an history of tobacco and alcohol use. Methods: A retrospective review of 950 HNSCC treated in our institute between January 1996 and June 2003 was undertaken. Characteristics of patients with history of tobacco and alcohol use were compared with those who were not at risk. Among all patients, 58 (6.1%) of them had no history of tobacco and alcohol use. These patients have been apparied with 59 case control patients who had an history of tobacco and alcohol use. Results: We found no statistical difference between the two groups for age, cancer histology and treatment. Female were predominant in the non at-risk group (p<0.0001, OR: 12.9). Epidermal Growth Factor Receptor tumoral level (EGFR) was less expressed in the non at-risk group (mean+-sd, 88.2+-2.53 and 198.0+-3.15 fmol/mg protein for non at-risk and at risk patients, respectively). Disease free survival was significantly longer in the non at-risk group (logrank test, p=0.037). No difference was observed between the two groups in terms of overall survival. Conclusions: A female predominance in non at-risk HNSCC patients is confirmed. Tobacco and alcohol use may interfere with cellular signaling pathway involving the EGFR. The difference in DFS could be related to the important comorbidity classically encountered in the tobacco and alcohol user group. No significant financial relationships to disclose.