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Neck Cancers

Determining Your Prognosis

Your prognosis is a prediction of the outcome of your disease. What is the risk of succumbing to the cancer or the risk of its coming back? These are the big questions on most people’s minds after receiving a diagnosis of head and neck cancer.

It is very difficult to discuss prognosis without understanding all the details of your cancer, and this is a conversation you’re better off having in person with your doctor. To give you a percentage chance of cure is really difficult because cancer research looks at all sorts of different types of cancers and may include patients from long ago.

You should read about different primary tumor sites to learn about prognosis for different tumors. For cancers with an unknown primary, you can see the section on metastatic lymph nodes. Below is prognosis of two types of primary neck cancers, sarcoma and lymphoma.

Sarcoma

For soft tissue sarcomas, stage can help predict the prognosis. The higher the stage, the lower the overall survival.

Based on an analysis of national databases of a number of different types of sarcomas in adults (in all sites, not just the head and neck, in patients over the age of 19), the following estimated disease-specific survival rates were found8 Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.:

Histological Type ALL STAGES LOCAL REGIONAL DISTANT ALL STAGES
5-Year Estimated Disease-Specific Survival 5-Year Estimated Disease-Specific Survival 5-Year Estimated Disease-Specific Survival 5-Year Estimated Disease-Specific Survival 10-Year Estimated Disease-Specific Survival
Total 50% 83% 83% 16% 44%
Perivascular sarcoma 63% 82% 82% 43% 48%
Liposarcoma 83% 91% 91% 31% 74%
Dermatofibrosarcoma 100% 100% 100% N/A 99%
Other fibrosarcoma 72% 88% 54% 24% 65%
Fibrohistiocytic sarcoma 67% 81% 55% 12% 64%
Leiomyosarcoma 52% 72% 44% 14% 43%
Rhabdomyosarcoma 35% 59% 40% 6% 31%
Kaposi’s sarcoma 25% N/A N/A N/A 19%
Vascular sarcomas excluding KS 36% 58% 32% 13% 30%
Chondro-osseous sarcomas 55% 62% 66% N/A 48%
Sarcomas of uncertain differentiation 56% 80% 49% 17% 51%

Estimated disease-specific survival is the percentage of people with a specific cancer who are alive at a given time, such as five years after diagnosis. It excludes people who may have died from a disease other than their cancer. It is probably the best estimate we have in these large national databases as to the prognosis of a particular type of cancer at each stage.

Lymphoma

To look at prognosis for lymphoma, we separated Hodgkin lymphoma and Non-Hodgkin lymphoma and then broke down estimated disease-specific survival rates based on stage and type of lymphoma. Again, this is all based on national data from the Surveillance Epidemiology and End Results (SEER) database.8 Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.

  • Hodgkin lymphoma: In general, the prognosis for Hodgkin lymphoma is quite good. Higher stage is associated with a worse prognosis. Of the different subtypes, Lymphocyte Depleted has the worst prognosis.

 

 

  • Non-Hodgkin lymphoma (NHL): The survival statistics based on stage are shown here. Also, we’ve used the SEER data to show you survival based on some different types of non-Hodgkin lymphomas (NHLs).Nodular Lymphocyte Predominance (Nodular LP)
  • Nodular Sclerosing (NS)
  • Mixed Cellularity (MC)
  • Lymphocyte Depletion (LD)
  • Not Otherwise Specified (NOS)

 

 

References

1 Gurney JG, Young JL, Roffers SD, Smith MA, Bunin GR. SEER pediatric monograph – soft tissue sarcomas. National Cancer Institute. Page 111. http://seer.cancer.gov/publications/childhood/softtissue.pdf.

2 Fletcher CDM, Rydholm A, Singer S, Sundaram M, Coindre JM. Soft Tissue Tumours. In: Barnes EL, Eveson JW, Reichart P, Sidransky D, editors. World Health Organization classification of tumours: pathology & genetics WHO Classification. Lyon: IARCPress; 2005.

3 Zhang MQ, El-Mofty SK, Dávila RM. Detection of human papillomavirus-related squamous cell carcinoma cytologically and by in situ hybridization in fine-needle aspiration biopsies of cervical metastasis: a tool for identifying the site of an occult head and neck primary. Cancer. 2008;114(2):118-23.

4 Cunningham MJ, Myers EN, Bluestone CD. Malignant tumors of the head and neck in children – a 20 year review. International Journal of Pediatric Otorhinolaryngology. 1987;(13)3:279-292.

5 Edge SB, et al. The AJCC Cancer Staging Manual – Seventh Edition. American Joint Committee on Cancer 2010. Page 611.

6 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2013. © National Comprehensive Cancer Network, Inc 2013. All rights reserved. Accessed June 20, 2013. To view the most recent and complete version of the guideline, go online to www.nccn.org. NATIONAL COMPREHENSIVE CANCER NETWORK®, NCCN®, NCCN GUIDELINES®, and all other NCCN Content are trademarks owned by the National Comprehensive Cancer Network, Inc.

7 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Soft Tissue Sarcoma V.1.2013. © National Comprehensive Cancer Network, Inc 2013. All rights reserved. Accessed July 17, 2013. To view the most recent and complete version of the guideline, go online to www.nccn.org. NATIONAL COMPREHENSIVE CANCER NETWORK®, NCCN®, NCCN GUIDELINES®, and all other NCCN Content are trademarks owned by the National Comprehensive Cancer Network, Inc.

8 Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.