Stage-Wise Presentation of Non-Metastatic Head and Neck Cancer: an Analysis of Patients from the Kumaon Hills of India

  • Published : 2014.06.30


Background: Head and neck cancer without distant metastases is amenable to various modalities of treatment. However, the stage at presentation is a very important determinant for treatment success. The present study was conducted to determine the stage-wise presentation of non-metastatic head and neck cancer patients from the hilly regions in Kumaon division of Uttarakhand, India. Materials and Methods: The hospital records for non-metastatic head and neck cancer patients from the only functional cancer centre of the region for the period of two-years (January 2012-December 2013) were included. Nasopharyngeal carcinoma was excluded due to its staging system being different. Non-squamous histopathologies were also excluded. Patients hailing from nearby regions of Uttar Pradesh and Nepal were excluded, as were patients from non-hilly regions of Kumaon. Results: Of the 271 patients of head and neck cancer, 27 with distant metastases at diagnosis were excluded from the analysis. Of the 244 eligible patient records, 90.1% (n=222) were male, and 9.9% (n=22) were female. The proportions of patients with carcinoma of the larynx, oropharynx, oral cavity, hypopharynx and maxillary antrum were 31.9% (n=78), 27.9% (n=68), 20.5% (n=50), 12.7% (n=31) and 1.2% (n=3). A further 5.7% (n=14) were diagnosed as having secondary involvement of neck nodes with unknown primaries. The proportion of patients presenting in stages I, II, III, IVA and IVB were 0.8% (n=2), 2.5% (n=6), 9.4% (n=23), 51.6% (n=126) and 35.7% (n=87) respectively. Conclusions: An abysmally low proportion (3.3%) of non-metastatic head and neck cancer patients presented in the early stages (I and II). A vast majority of the patients (88.1%) presented with stages IVA and IVB. Not only does this reflect a poor therapeutic outlook, but also exposes the dire need for programmes focusing on cancer awareness and early detection in the region.


  1. Addala L, Pentapati CK, Reddy Thavanati PK, et al (2012). Risk factor profiles of head and neck cancer patients of Andhra Pradesh, India. Indian J Cancer, 49, 215-9.
  2. Bag A, Rawat S, Pant NK, et al (2012) Cancer patterns in Nainital and adjoining districts of Uttarakhand: A one year survey. J Nat Sci Biol Med, 3, 186-8.
  3. Bhurgri Y, Bhurgri A, Usman A, et al (2006). Epidemiological review of head and neck cancers in Karachi. Asian Pac J Cancer Prev, 7, 195-200.
  4. Census, India 2011. Available at HYPERLINK "" District census 2011.
  5. Chaudhry S, Khan AA, Mirza KM, et al (2008). Estimating the burden of head and neck cancers in the public health sector of Pakistan. Asian Pac J Cancer Prev, 9, 529-32.
  6. Edge SB, Byrd DR, Compton CC, et al (2010). AJCC cancer staging handbook from the AJCC cancer staging manual, 7th edn. Springer, New York, pp 63-79
  7. Elango JK, Gangadharan P, Sumithra S, et al (2006). Trends of head and neck cancers in urban and rural India. Asian Pac J Cancer Prev, 7, 108-12.
  8. Goyal S, Tiwari VK, Nair KS, Raj S (2014). Risk factors and costs of oral cancer in a tertiary care hospital in Delhi. Asian Pac J Cancer Prev, 15, 1659-65.
  9. Gress DM (2002). Your cancer registry: more than just case counts. Oncol Issues, 17, 28-31
  10. Kulkarni MR (2013). Head and neck cancer burden in India. International Journal of Head and Neck surgery, 4, 29-35.
  11. Lasrado S, Prabhu P, Kakria A, et al (2012). Clinicopathological profile of head and neck cancers in the Western development region, Nepal: a 4-year snapshot. Asian Pac J Cancer Prev, 13, 6059-62.
  12. Mishra A, Meherotra R (2014). Head and neck cancer: global burden and regional trends in India. Asian Pac J Cancer Prev, 15, 537-50.
  13. Mohanti BK, Nachiappan P, Pandey RM, et al (2007). Analysis of 2167 head and neck cancer patients' management, treatment compliance and outcomes from a regional cancer centre, Delhi, India. J Laryngol Otol, 121, 49-56.
  14. Negi SS (1991). Himalayan rivers, lakes, and glaciers. Indus Publishing Company, New Delhi, pp 9-31.
  15. Negi SS (1995). Uttarakhand Land and People. MD Publications, New Delhi, pp 85-105.
  16. Saklani DP (1998). Ancient communities of the Himalaya. Indus Publishing Company, New Delhi, pp 13-28.
  17. Siddiqui MS, Chandra R, Aziz A, Suman S (2012). Epidemiology and histopathological spectrum of head and neck cancers in Bihar, a state of Eastern India. Asian Pac J Cancer Prev, 13, 3949-53.
  18. Siegel R, Ma J, Zou Z, et al (2014). Cancer statistics, 2014. CA Cancer J Clin, 64, 9-29.

Cited by

  1. Weekly Cisplatin-Based Concurrent Chemoradiotherapy for Treatment of Locally Advanced Head and Neck Cancer: a Single Institution Study vol.16, pp.16, 2015,
  2. Concurrent Chemoradiation with Weekly Cisplatin for the Treatment of Head and Neck Cancers: an Institutional Study on Acute Toxicity and Response to Treatment vol.16, pp.16, 2015,
  3. Survival in Head and Neck Cancers - Results of A Multi-Institution Study vol.17, pp.4, 2016,