Head and Neck cancer (HNC) is the 6th most common cancer worldwide. Its recurrence probability is known as the greatest obstacle to prolong survival rate. Objectives: This study was conducted to assess survival and recurrence rate of HNC and their associated risk factors. Methods: This retrospective cohort study was conducted on 179 HNC patients, who were diagnosed from April 2007 to November 2013 in Tehran, Iran. Two outcomes were simultaneously analyzed: time between diagnosis and disease

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... rrence or interrecurrences; the time between diagnosis and death or end of the study. Kaplan-Meier curve, log-rank test, and general joint frailty model were utilized to data analysis, using Stata 11.0 and R. Results: From 179 patients, 52.5% experienced relapse at least once and 15.6% of cases deceased. The survival rate in 12-, 24-, and 60-month were 94.4, 83.1%, and 55.4%, respectively. The median of survival time was 60.92 (1.1 -72.9) months, which was longer in patients with relapse (63.62 versus 24.16). Advanced stage and the age older than 50 significantly increased the risk of death about 4-fold and 3-fold (P = 0.007, P = 0.014). Moreover, the initial treatment of surgery + radiotherapy + chemotherapy had significantly raised the hazard of relapse (P < 0.001). Conclusions: The percentage of deceased patients in relapse group was more than non-relapses, but the median of survival time in them was longer. Early detection can prevent recurrent events and the premature death of HNC patients.