Positive factors on survival of head and neck cancer of unknown primary: what the clinician can do.
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| Title: | Positive factors on survival of head and neck cancer of unknown primary: what the clinician can do. |
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| Authors: | Khalil, Firas (AUTHOR), Koch, Michael (AUTHOR), Iro, Heinrich (AUTHOR), Sievert, Matti (AUTHOR), Haderlein, Marlen (AUTHOR), Semrau, Sabine (AUTHOR), Fietkau, Rainer (AUTHOR), Agaimy, Abbas (AUTHOR), Scherl, Claudia (AUTHOR) |
| Source: | Acta Oto-Laryngologica. Sep2023, Vol. 143 Issue 9, p829-834. 6p. |
| Subjects: | Cancer patient psychology, Statistics, Multivariate analysis, Head & neck cancer, Retrospective studies, Decision making, Descriptive statistics, Physicians, Overall survival, Disease management, Squamous cell carcinoma |
| Abstract (English): | Management of patients with head and neck cancer of unknown primary (HNCUP) is challenging. To provide a long-term analysis focusing on protective survival factors for clinical decision-making. Furthermore, the prognostic value of the current N classification system was evaluated. We retrospectively analyzed patients with HNCUP between 2003 and 2016. Univariate and multivariate analyses were used to investigate predictors of overall survival (OS). A primary tumor was found in 67 of 290 patients with suspected HNCUP, leaving after exclusion 141 HNCUP cases for analysis, who received multi-step therapy (MST) (n = 108) or single therapy (n = 28). Chemotherapy (CT) (n = 101), curative MST, ≤3 positive lymph nodes (LN) (n = 33), squamous cell carcinoma (SCC) (n = 123), HPV+ (n = 21), M0 (n = 70) increased OS by 21.8%, 24.4%, 12.7%, 6.8%, 18.7%, 29.6%, respectively. 5- and 10-year OS was 78.1%/66.6%. The number of metastatic LNs predicted OS is better than N classification. Aspects for clinical decision-making: Curative MST and SCC histology were the most significant predictors for improved OS. Categorizing LN into 1, 2-3, and >3 LNs was more significant than the traditional N classification. The addition of CT to curative MST has a stronger impact on survival than HPV and N classifications. [ABSTRACT FROM AUTHOR] |
| Abstract (Chinese): | 背景: 原发灶不明的头颈癌 (HNCUP) 患者的治疗是具有挑战性的。 目的: 为临床决策提供以保护性生存因素为重心的长期分析。 此外, 还评估了当前 N 分类系统的预后价值。 材料和方法: 我们回顾性分析了 2003 年至 2016 年间的 HNCUP 患者。使用单变量和多变量分析来研究总生存期(OS)的预测因素。 结果: 290 名疑患 HNCUP 的患者中, 81 名发现原发肿瘤, 剩下 141 名 HNCUP病例 有待分析。这些病例接受了多步治疗(MST)(n = 108)或单一治疗(n = 28)。化疗 (CT) (n = 101)、治愈性 MST、≤3 个阳性淋巴结 (LN) (n = 33)、鳞状细胞癌 (SCC) (n = 123)、HPV+ (n = 21)、M0 (n = 70) 使 OS 分别提高了 21.8%、24.4%、12.7%、6.8%、18.7%、29.6%。 5 年和 10 年 OS 分别为 78.1%和66.6%。 预测 OS 的转移淋巴结数量优于N分类。 结论和意义: 临床决策方面: 治愈性 MST 和 SCC 组织学是改善 OS 的最重要的预测因素。 将 LN 分类为 1、2-3 和 > 3 个 LN比传统的N分类更显著。 治疗性 MST 添加 CT , 与 HPV 和 N 分类相比, 对生存的影响更大。 [ABSTRACT FROM AUTHOR] |
| Copyright of Acta Oto-Laryngologica is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
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| Abstract: | Management of patients with head and neck cancer of unknown primary (HNCUP) is challenging. To provide a long-term analysis focusing on protective survival factors for clinical decision-making. Furthermore, the prognostic value of the current N classification system was evaluated. We retrospectively analyzed patients with HNCUP between 2003 and 2016. Univariate and multivariate analyses were used to investigate predictors of overall survival (OS). A primary tumor was found in 67 of 290 patients with suspected HNCUP, leaving after exclusion 141 HNCUP cases for analysis, who received multi-step therapy (MST) (n = 108) or single therapy (n = 28). Chemotherapy (CT) (n = 101), curative MST, ≤3 positive lymph nodes (LN) (n = 33), squamous cell carcinoma (SCC) (n = 123), HPV+ (n = 21), M0 (n = 70) increased OS by 21.8%, 24.4%, 12.7%, 6.8%, 18.7%, 29.6%, respectively. 5- and 10-year OS was 78.1%/66.6%. The number of metastatic LNs predicted OS is better than N classification. Aspects for clinical decision-making: Curative MST and SCC histology were the most significant predictors for improved OS. Categorizing LN into 1, 2-3, and >3 LNs was more significant than the traditional N classification. The addition of CT to curative MST has a stronger impact on survival than HPV and N classifications. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 00016489 |
| DOI: | 10.1080/00016489.2023.2265937 |
