Effectiveness of a Structured Nursing Care Pathway Integrated with Standard Pharmacological Management on Biophysiological and Psychological Outcomes in Patients Undergoing Spinal Anesthesia: A Pilot

Head and neck cancers (HNC) comprise those that begin on the mucosal surfaces of the head and neck region, including the oral cavity, nasopharynx, oropharynx, hypopharynx, larynx, salivary glands, nasal cavity and paranasal sinuses. The most common histological type of HNC is head and neck squamous cell carcinoma (HNSCC), originating in the squamous cells that line the mucosa of the head and neck organs [,]. Some sources classify oesophageal cancer (ESCC) as head and neck cancer (HNC) based on its similar histology: the tumour is also a squamous cell carcinoma arising from the squamous epithelium of the upper gastrointestinal tract, i.e., the cervical part of the oesophagus, which is histologically identical to the epithelium lining the upper respiratory tract. As these cancers derive from anatomically related organs with shared risk factors, smoking and regular alcohol consumption, head and neck cancers are also referred to as upper aerodigestive tract cancers (UADT) []. A recent multi-year, multi-population study from the Global Cancer Statistics Group (GLOBOCAN 2022) found HNSCC to constitute the seventh most common cancer globally, accounting for ~4.7% of human malignancies, the condition is newly diagnosed in over 946,456 patients and contributes to nearly 482,001 deaths []. The tumour mainly affects men, who are at two to fourfold higher risk than women for developing HNSCC. It has been predicted that the incidence of HNSCC will increase by 30% by 2030, resulting in an estimated 1.08 million new cancer cases per year [,,]. Oesophageal cancer is also widespread: it is the eleventh most commonly diagnosed cancer and the seventh cause of death worldwide; it constitutes 2.6% of all cancers globally, and is responsible for 510,716 new cases and 445,000 deaths. Also, the cancer is diagnosed two to three times more often in men than in women, and its highest incidence rate is observed in Eastern Asia and Eastern Africa. Histologically, squamous cell carcinoma represents one-third of oesophageal cancer subtypes. HNSCC and ESCC together constitute ~7% of all human cancers: approximately 1.3 million UADT cancer cases and 830,000 deaths were reported in 2022 [,]. Unfortunately, despite the use of modern surgical procedures and advanced combined oncological treatment methods, the five-year survival rate of patients with HNSCC remains below 40–60%. This is mainly due to delayed diagnosis, with most cases detected at WHO stages III and IV. The diseases are also characterised by rapid development of neoplastic lesions and aggressive course, as well as frequent lymph node metastases, local tumour recurrence and chemoradioresistance [,].