Squamous cell carcinoma of unknown primary of the head and neck: Favorable prognostic factors comparable to those in oropharyngeal cancer

Margaret J. Zhou, Annemieke van Zante, Ann A. Lazar, Eli R. Groppo, Adam A. Garsa, William R. Ryan, Ivan H. El-Sayed, David W. Eisele, Sue S. Yom

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Treatment for squamous cell carcinoma (SCC) of unknown primary consists of radiotherapy (RT) +/- chemotherapy or neck dissection +/- adjuvant RT/chemoradiotherapy (CRT). We compared these strategies and identified prognostic factors. Methods: From 1993 to 2015, 75 patients with SCC of unknown primary had RT-based or surgery-based treatment. Primary endpoints were overall survival (OS) and disease-free survival (DFS). Event-time distributions were estimated using the Kaplan-Meier method. Results: Five-year OS and DFS for RT-based and surgery-based treatments were similar (OS 73% vs 68%, respectively; DFS 65% vs 64%, respectively). Among 38 patients with p16 data, 76% were p16 positive and showed improved 5-year DFS (90% vs 33%; P =.001) and OS (96% vs 33%; P <.001). Smoking history ≤10 pack-years conferred better 5-year DFS (88% vs 49%; P <.001) and OS (91% vs 59%; P <.001). Conclusion: RT-based and surgery-based treatments produced similar outcomes. Patients with p16-positive disease with ≤10 pack-years of smoking history and limited nodal stage constitute a “low-risk” group in SCC of unknown primary similar to that in oropharyngeal cancer.

Original languageEnglish (US)
Pages (from-to)904-916
Number of pages13
JournalHead and Neck
Volume40
Issue number5
DOIs
StatePublished - May 2018

Keywords

  • p16
  • radiation
  • squamous cell carcinoma
  • surgery
  • unknown primary

ASJC Scopus subject areas

  • Otorhinolaryngology

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