Natural history of untreated head and neck cancer

This paper describes the characteristics and natural history of the largest reported group of patients with untreated head and neck cancer. From 1953 to 1990, 808 untreated head and neck cancer patients were followed-up until their death. All patients were given supportive care, but specific oncolog ical treatment was not pursued secondary to advanced tumour stage, poor per formance status and/or patients' refusal of any treatment. The overall surv ival ranged from 1 day to 53.8 months (median 3.82 months). Performance sta tus was the most significant predictor of survival (P < 0.001). A subgroup of 357 patients with good performance status and aged less than 70 years ol d had a 12.9% 1-year survival. Approximately 50% of untreated head and neck cancer patients will die within 4 months of their diagnosis. However, the remaining patients tan survive up to 4 or more years, depending on their tu mour location, extent, performance status and level of supportive care. (C) 2000 Published by Elsevier Science Ltd. All rights reserved.