Friday, April 11, 2008

Prognosis Statistics

After my last blog entry, I began wondering (to myself), how statistically fortunate am I to have survived this long after my initial diagnosis. With Google in one hand and an inquisitive mind in the other (as they say, inquisitive minds want to know), I set off to answer this question.

A fine needle aspiration biopsy on April 29 2008 will mark my three year anniversary since my initial diagnosis. But, my lymph nodes started to become swollen in January 2005, 4 months before my diagnosis. So, I’m somewhere in the 3 to almost 3.5 year survivorship range. Knowing what I know now, I found two helpful websites to help answer this question.

The first website was one that further defined the stages of squamous cell carcinoma of the head and neck (SCCHN). It looked at primary tumor size, localized lymph node involvement, and further area metastasis. It rated each of these factors. (Reference 1). I’m taking an educated guess at some of these, but here is my assessment:
- Primary Tumor (T2) – Greater than 2 cm, less than 4 cm
- Lymph Nodes (N2, but maybe N3) – Evidence of movable or fixed local lymph nodes
- Distant Metastasis (M0) – No evidence of distant metastasis

In summary, I had stage IV SCCHN with T2, (N2 or maybe N3), and M0.

The fun doesn’t end here however. What does this mean? The second website (reference 2) divided stage IV into 2 groups. One group had “relatively” good results and the other had very poor results (to say the least). They were divided based on the above T, N, and M ratings. Patients with the new favorable stage IV have a 5-year survival rate of 30%, and those with the new unfavorable stage IV had a survival rate of 0%.

I fall on the borderline side of a favorable stage IV. I think that’s why my treatment has been so aggressive and my recurrences have been so frequent. In 2 years I’ll reach the 5 year mark. That’s a long way off when you’re living a day at a time. But 3 out of 10 people are still here then and I hope to be one of them.

It would have been interesting for the study to state the percent of cases which were on each side of favorable and unfavorable, but it was not available in the referenced article.

Take care.

References
1. http://www.emedicine.com/plastic/topic376.htm
2. http://linkinghub.elsevier.com/retrieve/pii/S0385814699000048

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