6th ICHNO Abstract Book

page 18 6 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 16 – 18 March 2017 Barcelona, Spain __________________________________________________________________________________________ 6th ICHNO

other primary cancer sites and Charlson comorbidities. Death records from PMSI were compared to National causes-of-death statistics (CEPIDC) using the same ICD-10 definitions. The mortality gap (PMSI minus CEPIDC) was described overall and by sex, age category, region, H&N cancer site, and year. We further explored the role of primary cancer other than H&N cancer and Charlson comorbidities other than cancer on misclassification bias (i.e., a positive mortality gap) in multivariate Poisson regression. Results Of 94,672 French patients identified with H&N cancer in 2008-2012, 41,503 patients with advanced H&N cancer died at hospital. In comparison, 25,647 (61.8%) deaths were attributed to H&N cancers in National causes-of- death statistics during the same period. Misclassification bias increased from 2008 to 2012 (+8% by year). In multivariate Poisson regression, misclassification bias was maximum in patients with oral cavity or oropharynx cancer (except tongue), and misclassification bias was higher in patients with hypopharynx cancer as compared to laryngeal cancer. Misclassification bias significantly increased in presence of another primary cancer recorded before or at diagnosis of H&N cancer or distant metastasis. Misclassification bias was not associated with severe comorbidities other than cancer, but significantly increased in patients receiving palliative care. Correcting for mortality outside hospital would worsen the mortality gap from 38.2% to 49.8%. Conclusion The study results suggest that the actual burden of H&N cancer is underestimated by at least a third by French National causes-of-death statistics. Misclassification bias of the number of deaths attributable to H&N cancer increased in the recent years. PD-030 Survival of patients with head and neck cancers in France (EPICORL study) F. Huguet 1 , L. Geoffrois 2 , B. Le Vu 3 , Y. Pointreau 4 , M. Bec 5 , C. Even 6 , L. Lévy-Bachelot 5 , S. Temam 6 , M. Schwarzinger 7 1 Hôpital Tenon, Department of Radiotherapy, Paris Cedex 20, France 2 Institut de Cancérologie de Lorraine - Alexis Vautrin, Medical Oncology, Vandoeuvre Les Nancy, France 3 UNICANCER Fédération Nationale des Centres de Lutte Contre le Cancer, Stratégie et Gestion Hospitalière, Paris, France 4 Centre Jean Bernard, Oncology, Le Mans, France 5 MSD France, Market access, Courbevoie, France 6 Institut Gustave Roussy, Head & Neck Surgical & Medical Oncology, Villejuif, France 7 THEN Translational Health Economics Network, Public Health, Paris, France Purpose or Objective The aim of this study was to have an exhaustive description of the recent epidemiology of head and neck squamous cell carcinoma (H&N SCC) patients in France. Material and Methods We completed a retrospective cohort study using the French National Hospital Discharge (PMSI) database. We identified all adult patients residing in Metropolitan France and diagnosed with H&N SCC (ICD-10: C00-C06; C09-C14; C30.0; C31; C32) in 2008-2012. Cancer location and stage (early I/II; locally advanced III/IVb; distant metastatic IVc) were determined at diagnosis. Time to relapse, secondary primary H&N cancer, other primary cancers, Charlson comorbidities were recorded until last hospital stay in 2013. Hazard ratios (HR) for in-hospital death were estimated in

a multivariate Cox model with use of time-dependent variables. Results 131,965 French adults were identified with H&N SCC at hospital in 2008-2012: 79.4% were male with median (IQR) age of 61 (54-71) at diagnosis. Survival at 5 years was 34.0% (95% CI, 33.5%-34.4%) over a follow-up of 196,000 person-years. As compared to 23.2% patients with laryngeal cancer, survival was significantly lower for 29.3% patients with oral cavity cancer (HR=1.24), 19.5% patients with oropharynx cancer (HR=1.22), or 12.8% patients with hypopharynx cancer (HR=1.26). As compared to 30.7% patients with early cancer at diagnosis, survival was significantly lower for 57.2% patients with advanced cancer (HR=1.65) and 12.1% patients with distant metastasis (HR=6.19). Relapse rate at 3 years was 31.9% in patients with early cancer and 51.8% in patients with advanced cancer, with significantly lower survival (HR=5.92). Secondary primary H&N cancers were detected in 6.1% patients at diagnosis (HR=1.15) and 3.2% patients at 3 years (HR=1.70). During the study period, about 31% patients had another primary cancer (including 10.1% lung) and about 52% patients had severe comorbidities other than cancer incurring significantly lower survival. Conclusion This is the first national study on the epidemiology and survival of patients with H&N SCC in France. Distant metastasis at diagnosis and relapse in patients with early or locally advanced cancer had the strongest impact on prognosis. In addition, about two-third patients had another primary cancer or severe comorbidities other than cancer worsening prognosis over time. PD-031 Quality of life, health status and work in head and neck cancer survivors treated with radiotherapy A. Matías-Pérez 1 , B. G. Díaz de Tudanca 1 , G. Gallego- Herreros 1 , M. Sánchez-Barba 2 , P. Soria-Carreras 1 , A. Nieto-Palacios 1 , A. Rodríguez-Gutierrez 1 , L.A. Pérez- Romasanta 1 1 Hospital Universitario de Salamanca, Radiation Oncology Department, Salamanca, Spain 2 Universidad de Salamanca, Statistics Department, Salamanca, Spain Purpose or Objective Head and neck cancer (HNC) survivors are an increasing population, due to the improvement in diagnosis and treatment. The aim of this study is to analyse the quality of life, health status, psychological status and work activity in HNC survivors. Material and Methods The population was composed of a series of 50 HNC patients (>3 years post-diagnosis) treated in our institution from 2006 to 2013, having no signs of cancer recurrence to date. Quality of life was measured with EORTC QLQ-C30 and HN35. The health status items measured were: nutritional assessment using the Malnutrition Universal Screening Tool (MUST), cardiovascular risk (with the HeartScore® tool), toxic habits (tobacco and alcohol by the Alcohol Use Disorders Identification Test (AUDIT)) and physical activity (with the Global Physical Activity Questionnaire(GPAQ)). Psychological evaluation was performed by the State-Trait Anxiety Inventory (STAI) and the State-Trait Depression Inventory (STDI). Patients were asked about their work status before and after cancer treatment. Results The mean age was 64 years (range, 43-84 years) and 46 patients (92%) were male. The most frequent site of the primary tumour was larynx (48%) and the main histology squamous cell carcinoma (76%). 72% of patients had advanced cancers (stages III and IV), whereas 26% had