{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T06:55:34Z","timestamp":1761893734504,"version":"build-2065373602"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2002,7,23]],"date-time":"2002-07-23T00:00:00Z","timestamp":1027382400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2002,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>During the last 20 years, survival rates of head and neck carcinoma patients in the United States and Europe have plateaued. To determine the factors that can reduce mortality rates, we examined changes in clinical presentation and survival rates across 24 years of treatment of head and neck carcinoma patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A retrospective study of patients with head and neck carcinoma was conducted from January 1, 1975, to December 31, 1998. We identified 2143 eligible patients with squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, and larynx. Changes in gender, clinical stage, and therapy were evaluated separately for each site of cancer across five consecutive periods. Probability of dying and overall survival rates were estimated. Odds ratios (ORs) and hazard ratios were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>An increase in T1 versus T2 or higher stage carcinoma was more probable for the oral cavity and larynx (OR = 4.1 and 3.0, respectively) in the last versus the earliest period. An increase in radical treatments was more probable for carcinomas of the oral cavity, oropharynx, hypopharynx, and larynx (10.2, 34.8, 12.5, and 2.1\u2010fold, respectively) in the last versus the earliest period. A decreasing trend of probability of dying from the first head and neck carcinoma during the 1970s versus the 1990s was found. The overall survival rates at 5 years was 32% in 1975\u20131978 versus 51% in 1989\u20131993.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>In contrast with survival rates in the United States and Europe, our findings show a significant increase in overall survival rates during the last 20 years. This increase is attributable to changes in diagnostic\u2010therapeutic approaches and to early consultation with a physician for symptoms arising in the head and neck region. Cancer 2002;95:540\u201352. \u00a9 2002 American Cancer Society.<\/jats:p><jats:p>DOI 10.1002\/cncr.10682<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.10682","type":"journal-article","created":{"date-parts":[[2002,10,6]],"date-time":"2002-10-06T07:53:08Z","timestamp":1033890788000},"page":"540-552","source":"Crossref","is-referenced-by-count":12,"title":["Changes in presentation and survival of head and neck carcinomas in Northeastern Italy, 1975\u20131998"],"prefix":"10.1002","volume":"95","author":[{"given":"Luigi","family":"Barzan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato","family":"Talamini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianni","family":"Franchin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuela","family":"Vaccher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doriano","family":"Politi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilio","family":"Minatel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Gobitti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2002,7,23]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)92456-P"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1996.141"},{"key":"e_1_2_6_4_2","first-page":"7","article-title":"Cancer statistics, 2000","volume":"50","author":"Greenlee RT","year":"1994","journal-title":"CA."},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0964-1955(94)90016-7"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19950315)75:6<1343::AID-CNCR2820750617>3.0.CO;2-T"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199301213280306"},{"key":"e_1_2_6_8_2","first-page":"1","volume-title":"Cancer of the head and neck","author":"Sisson GA","year":"1996"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8588(05)70084-8"},{"key":"e_1_2_6_10_2","first-page":"768","volume-title":"Cancer of the head and neck","author":"Laramore GE","year":"1996"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0167-8140(92)90242-M"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-8140(97)00079-0"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(97)00768-2"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(81)90079-1"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1517\/13543784.9.12.2855"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)90011-4"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(98)00226-0"},{"key":"e_1_2_6_18_2","first-page":"33","volume-title":"Cancer of the head and neck","author":"Piccirillo JF","year":"1996"},{"volume-title":"Atlas of cancer mortality in northeastern regions and provinces and in Italy, 1990\u201394","year":"1999","author":"Bidoli E","key":"e_1_2_6_19_2"},{"key":"e_1_2_6_20_2","first-page":"129","article-title":"Studio pilota sullo screening per la diagnosi precoce dei tumori delle prime vie aero\u2010digestive in soggetti a rischio in Friuli\u2010Venezia Giulia","volume":"10","author":"Barzan L","year":"1990","journal-title":"Acta Otorhinolaryngol Ital."},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/0964-1955(94)90022-1"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1368-8375(97)00034-1"},{"key":"e_1_2_6_23_2","first-page":"13","volume-title":"TNM classification of malignant tumours","author":"UICC\u2010International Union Against Cancer","year":"1997"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19950215)75:4<1025::AID-CNCR2820750419>3.0.CO;2-2"},{"key":"e_1_2_6_25_2","first-page":"37","article-title":"Concomitant radiotherapy and chemotherapy in treatment of advanced, inoperable head and neck neoplasm. 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