Clinical prognostic factors for patients with recurrent head and neck cancer: Implications for randomized trials

The purpose of our study was to determine the clinical prognostic factors f or the duration of the overall survival from recurrence (OSR) in patients w ith recurrent head and neck squamous-cell carcinoma. We performed a retrosp ective analysis on 496 patients treated between 1982 and 1993 at the Antoin e Lacassagne Center. The significant favorable prognostic factors for the O SR were: initial T1-2 (p=0.008), no initial nodal involvement (p=0.002), no initial chemotherapy exposure (p=0.002), induction chemotherapy response ( p=0.001), duration of disease-free interval (DFI; p=0.0001), performance st atus (PS) 0-1 (p=0.004) and local-regional recurrence (p=0.001). In the mul tivariate analysis, the apparent nonsignificance of all factors apart from the DFI suggested that relevant prognostic factors could be embedded in the DFI. Multivariate analysis was performed after excluding the DFI. The resu lts indicated that local-regional recurrence, PS 0-1 and no initial chemoth erapy exposure remained significant favorable prognostic factors for the OS R. The advantages of taking into account such prognostic factors are to eli minate the patient selection bias and to ensure a fairer comparative evalua tion of new or already existing agents in recurrent head and neck cancer. C opyright (C) 2001 S. Karger AG, Basel.