Prognostic factors in recurrent or metastatic squamous cell carcinoma of the head and neck

Background: In clinical trials of recurrent and metastatic head and neck carcinoma, Argiris et al have identified prognostic factors for overall survival (OS) and progression-free survival (PFS), weight loss, Eastern Cooperative Oncology Group performance status (ECOG-PS), tumor primary site, tumor differentiation, prior radiotherapy, deriving a two-group prognostic classification. This study evaluates Argiris's classification in “field-practice” patients. Methods: The main analysis included 327 cases; a secondary analysis excluded 31 patients with oropharyngeal carcinoma (OPC) p16-positive and/or human papilloma virus (HPV)-positive. OS and PFS curves were estimated with the Kaplan-Meier method; multivariable Cox analyses were also performed. Results: In the full series, OS was significantly different in patients with 0-2 and ≥3 adverse features (median, 14 vs 10 months; P =.03). PFS was statistically different in the two groups (median, 7 vs 5 months; P =.02). At a multivariable analysis investigating additional prognostic features, site of relapse and disease-free interval were significant predictors of OS and PFS. Conclusion: The Argiris's model was confirmed in a “field-practice” population. Moreover, we found additional putative prognostic factors.