Survival times in end-stage head and neck cancer

A personal series of 4319 patients with a tumour of the head and neck managed between 1962 and 1988 is presented. Down to the end of 1979, 1678 of these patients had a squamous cell carcinoma that was previously untreated and of this group 200 patients were not treated. This represented 12% of the squamous carcinomas seen in that period. Untreatability ranged from 5% for laryngeal tumours to 25% for hypopharyngeal tumours. The median survival of the whole group was 101 days. Performance status (ECOG classification) was the only significant predictor of survival. Other host factors (age and sex) and all tumour factors (site, T, N and M stage, distant metastases, stage grouping, and histological grade of the tumour) were not significant. Only performance status needs to be used as a stratification factor in trials on this group of patients.