Higher Risk of Recurrence in Patients Treated for Head and Neck Cancer with Low BMI and Elevated Levels of C-Reactive Protein

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Spiegelberg, Diana,1982-Uppsala universitet,Plastikkirurgi,Cancerprecisionsmedicin (författare)

Higher Risk of Recurrence in Patients Treated for Head and Neck Cancer with Low BMI and Elevated Levels of C-Reactive Protein

Artikel/kapitelEngelska2022

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2022-10-21
MDPI,2022
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:uu-488220
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-488220URI
https://doi.org/10.3390/cancers14205161DOI

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Språk:engelska
Sammanfattning på:engelska

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Ämneskategori:art swepub-publicationtype

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Simple Summary Head and neck cancer (HNC) treatment poses several challenges in clinical practice, and treatment side effects can be debilitating due to the close proximity of important anatomical structures. Cancer recurrence post-treatment presents some of the most challenging HNC management issues. This prospective study identifies high-risk groups for recurrence of head and neck cancer, based on commonly accessible clinical parameters. In this study with 272 HNC patients, elevated pre- and post-treatment CRP levels, low BMI and advanced stage at admission indicate higher risk for recurrence of disease. Using these parameters, a risk model is proposed which may be useful for estimating the probability of cancer recurrence and allow the identification of high and low-risk patients. This prospective study identifies high-risk groups for recurrence of head and neck cancer by BMI and circulating inflammatory response markers. Head and neck cancer patients from three Swedish hospitals were included (n = 272). Leukocyte and thrombocyte counts, CRP levels, and BMI were measured pre-treatment and post-treatment. Associations between the four factors and treatment failure (residual tumor, loco-regional failure, general failure/distant metastasis) were assessed using a Cox proportional hazards model adjusted for sex, age at the initial visit, smoking status, cancer stage, and hemoglobin count. CRP level was the only significant single variable, with an average increase in risk of recurrence of 74% (p = 0.018) for every doubling. The predictive power of a combined model using all variables was highest during the initial months after treatment, with AUC under the ROC curve 0.75 at the 0-3 month timepoints. Patients with elevated pre- and post-treatment CRP levels are at higher risk for recurrence of disease. Male patients with low post-treatment BMI, advanced stage, and high CRP at any time post treatment are at high risk for recurrence. The combined model may be useful for stratifying post-treatment patients into low and high-risk groups, to enable more detailed follow-up or additional treatment regimens.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Cancer och onkologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cancer and Oncology hsv//eng
CRP
thrombocytes
BMI
leukocytes
squamous cell carcinoma
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Biuppslag (personer, institutioner, konferenser, titlar ...)

Malmberg, ChristerUppsala universitet,Institutionen för medicinska vetenskaper(Swepub:uu)chrma245 (författare)
Ehrsson, Ylva TiblomUppsala universitet,Öron-, näs- och halssjukdomar(Swepub:uu)ylvti687 (författare)
Laurell, GöranUppsala universitet,Öron-, näs- och halssjukdomar(Swepub:uu)gorla772 (författare)
Uppsala universitetPlastikkirurgi (creator_code:org_t)

Sammanhörande titlar

Ingår i:Cancers: MDPI14:202072-6694

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Cancers (Sök värdpublikationen i LIBRIS)

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Av författaren/redakt...: Spiegelberg, Dia ...; Malmberg, Christ ...; Ehrsson, Ylva Ti ...; Laurell, Göran

Om ämnet

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Cancer och onkol ...

Artiklar i publikationen: Cancers

Av lärosätet: Uppsala universitet

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