A model and nomogram to predict tumor site origin for squamous cell cancer confined to cervical lymph nodes

Arif N. Ali, Jeffrey M. Switchenko, Sungjin Kim, Jeanne Kowalski, Mark W. El-Deiry, Jonathan J. Beitler

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The current study was conducted to develop a multifactorial statistical model to predict the specific head and neck (H&N) tumor site origin in cases of squamous cell carcinoma confined to the cervical lymph nodes (“unknown primaries”). METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was analyzed for patients with an H&N tumor site who were diagnosed between 2004 and 2011. The SEER patients were identified according to their H&N primary tumor site and clinically positive cervical lymph node levels at the time of presentation. The SEER patient data set was randomly divided into 2 data sets for the purposes of internal split-sample validation. The effects of cervical lymph node levels, age, race, and sex on H&N primary tumor site were examined using univariate and multivariate analyses. Multivariate logistic regression models and an associated set of nomograms were developed based on relevant factors to provide probabilities of tumor site origin. RESULTS: Analysis of the SEER database identified 20,011 patients with H&N disease with both site-level and lymph node-level data. Sex, race, age, and lymph node levels were associated with primary H&N tumor site (nasopharynx, hypopharynx, oropharynx, and larynx) in the multivariate models. Internal validation techniques affirmed the accuracy of these models on separate data. CONCLUSIONS: The incorporation of epidemiologic and lymph node data into a predictive model has the potential to provide valuable guidance to clinicians in the treatment of patients with squamous cell carcinoma confined to the cervical lymph nodes. Cancer 2014;120:3469–3476.

Original languageEnglish (US)
Pages (from-to)3469-3476
Number of pages8
JournalCancer
Volume120
Issue number22
DOIs
StatePublished - Nov 1 2014

Keywords

  • End Results (SEER)
  • Epidemiology
  • Surveillance
  • cervical lymph nodes
  • predictive model
  • radiation
  • unknown primary

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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