Oncological Outcomes for Primary Head and Neck Squamous Cell Carcinoma in the United Kingdom: Results From a National Cross‐Sectional Cohort Study

Objectives To investigate overall survival outcomes from primary head and neck squamous cell carcinoma (HNSCC) in the UK. Design A retrospective national observational cohort study with consecutive participants. Setting UK‐wide head and neck cancer centres. Participants All patients with HNSCC who received a definitive treatment decision between 01/09/2021 and 30/11/2021. Subgroup analysis of patients was stratified by head and neck subsites. Main Outcome Measures Two‐year overall (OS), disease‐free (DFS), disease‐specific (DSS), and local‐recurrence‐free‐survival (LRFS) from primary HNSCC. Results Data from 1488 patients was submitted by 50 centres, of which 1286 were primary HNSCC. Median age was 65.5 years (IQR 57–74), and 911 (71.0%) were male. The most common subsites were oropharynx (37.6%), oral cavity (28.3%), larynx (22.0%), and hypopharynx (6.8%). Treatment intent was curative in 79.9% of cases. Of treatment modalities, 529 (41.3%) underwent surgery, 874 (68.4%) underwent radiotherapy, and 391 (30.7%) underwent chemotherapy. Two‐year OS, DFS, DSS and LRFS were 79.7%, 72.2%, 84.8%, and 75.1%, respectively. Two‐year OS was 83.5%, 55.4%, 73.9% and 84.6% for laryngeal, hypopharyngeal, oral cavity and oropharyngeal subsites, respectively. On multivariate analysis, clinical T staging, age, ECOG performance status, and p16 status were independent prognostic factors for survival. Conclusion UK survival variations according to disease subsite reflect larger studies. Broader data over larger periods will reveal whether long‐term improvements in the diagnosis, biological understanding, and treatments of HNSCC have translated into improvements in UK survival outcomes.