Squamous cell carcinoma untreated for 2 years
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Summary
9 papers analyzed
These studies suggest that untreated squamous cell carcinoma, particularly in the head and neck, has a very poor prognosis, with various treatment strategies showing mixed results in improving survival and response rates.
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Natural History and Prognosis of Untreated Squamous Cell Carcinoma
Introduction to Squamous Cell Carcinoma (SCC)
Squamous cell carcinoma (SCC) is a type of cancer that arises from squamous cells, which are flat cells found in the skin and mucous membranes. When left untreated, SCC can have severe consequences, particularly in the head and neck region.
Survival Rates and Prognosis of Untreated SCC
The prognosis for patients with untreated head and neck SCC is extremely poor. A study involving 206 patients with untreated head and neck SCC revealed that the 1-year survival rates for cancers in the oral cavity, oropharynx, throat, and hypopharynx were 31%, 20%, 0%, and 3%, respectively, with a significant difference in survival rates (p<0.001). The median survival time for these patients was only 11 months, and 57.2% of the patients died within 12 months. The T stage of the tumor was identified as the strongest predictor of survival time.
Treatment Approaches and Outcomes
Neoadjuvant Immunotherapy
Neoadjuvant immunotherapy, which involves administering treatment before the main treatment, has shown promise in improving outcomes for SCC patients. A phase 2 clinical trial investigated the use of nivolumab alone or in combination with ipilimumab in patients with untreated oral cavity SCC. The study found that both treatment arms showed promising response rates, with a 1-year progression-free survival of 85% and overall survival of 89%.
Induction Chemotherapy
Induction chemotherapy followed by locoregional treatment has been explored for locally advanced head and neck SCC. A phase II clinical trial compared two chemotherapy regimens followed by local therapy and found that the 2-year progression-free survival rates were 89% and 88% for the two regimens, respectively, showing a significant improvement compared to historical controls.
Combined Radiotherapy and Chemotherapy
A randomized trial compared alternating radiotherapy and chemotherapy with radiotherapy alone in patients with unresectable head and neck SCC. The combined treatment group had significantly better 5-year overall survival (24% vs. 10%), progression-free survival (21% vs. 9%), and locoregional relapse-free survival (64% vs. 32%) compared to the radiotherapy-only group.
Conclusion
Untreated squamous cell carcinoma, particularly in the head and neck region, has a very poor prognosis with low survival rates. However, various treatment strategies, including neoadjuvant immunotherapy, induction chemotherapy, and combined radiotherapy and chemotherapy, have shown promise in improving outcomes for patients with SCC. Early and aggressive treatment is crucial to enhance survival and quality of life for these patients.
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