Abstract
The number of oral cavity carcinoma (OCC) survivors continues to increase due to advances in definitive surgery and radiation therapy (RT), however the risk of ischemic stroke is unclear in long-term survivors. In this study, survivors are defined as those who survived for >5 years after a diagnosis of OCC. They were matched at a 1:5 ratio with normal controls. Those who received surgery alone versus surgery+RT were also matched at a 1:1 ratio. From 2000 to 2005, 5172 OCC survivors who received surgery alone (n = 3205) or surgery+RT (n = 1967), and 25,860 matched normal controls were analyzed using stratified Cox regression models. Adjusted HRs (aHR) revealed that the surgery+RT group (aHR = 1.68, p < 0.001) had an elevated risk of stroke, but this was not seen in the surgery alone group (aHR = 0.99, p = 0.953). Furthermore, the age at stroke onset was at least 10 years earlier in the surgery+RT group than in the controls. In conclusion, radiotherapy increased the risk of ischemic stroke by 68% and also accelerated the onset of stroke in long-term OCC survivors after primary surgery compared with matched normal controls. Secondary prevention should include stroke as a late complication in OCC survivorship programs.
Highlights
Oral cavity carcinoma (OCC) comprises 38.2% of all head and neck cancers and remains a main cause of morbidity and mortality in Taiwan, and accounts for 1.5% of all cancer cases globally [1]. it shares the same risk factors as oropharyngeal and laryngeal carcinomas such as smoking tobacco, alcohol consumption, and betel nut chewing, oral cavity carcinoma (OCC) remains primarily a surgical disease and adjuvant radiation is given to high-risk patients with or without chemotherapy, all of which contribute to an increased survival rate [2]
From 2000 to 2005, a total of 5172 eligible 5-year OCC survivors were identified from the Registry of Catastrophic Illnesses (RCI), and 25,860 normal controls matched by sex, age at index date, urbanization, and income-related insurance payment were selected from the Longitudinal Health Insurance Database
Most of the OCC survivors lived in the least urbanized areas (34.6%) and had the lowest income-related insurance payments (69.3%)
Summary
Oral cavity carcinoma (OCC) comprises 38.2% of all head and neck cancers and remains a main cause of morbidity and mortality in Taiwan, and accounts for 1.5% of all cancer cases globally [1]. It shares the same risk factors as oropharyngeal and laryngeal carcinomas such as smoking tobacco, alcohol consumption, and betel nut chewing, OCC remains primarily a surgical disease and adjuvant radiation is given to high-risk patients with or without chemotherapy, all of which contribute to an increased survival rate [2]. We conducted this population-based cohort study to investigate the association between radiation therapy (RT) and ischemic stroke, in long-term OCC survivors, defined as patients who had survived for longer than 5 years after diagnosis
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
