Small-cell carcinoma in the head and neck region: A propensity score-matched analysis of the effect of surgery

• Published in: PloS one 2024-10, Vol.19 (10), p.e0312455
• Main Authors: Hosokawa, Kiyohito, Takenaka, Yukinori, Sato, Takashi, Tsuda, Takeshi, Eguchi, Hirotaka, Suzuki, Masami, Kitamura, Koji, Fukusumi, Takahito, Suzuki, Motoyuki, Inohara, Hidenori
• Format: Article
• Language: English
• Subjects: Adult; Aged; Analysis; Cancer; Cancer therapies; Carcinoma; Carcinoma, Small Cell - mortality; Carcinoma, Small Cell - pathology; Carcinoma, Small Cell - surgery; Carcinoma, Small Cell - therapy; Care and treatment; Chemoradiotherapy; Chemotherapy; Disease; Epidemiology; Female; Head & neck cancer; Head and neck cancer; Head and neck carcinoma; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - surgery; Head and Neck Neoplasms - therapy; Humans; Kaplan-Meier Estimate; Lungs; Male; Medical prognosis; Medical research; Medicine and Health Sciences; Medicine, Experimental; Metastases; Metastasis; Middle Aged; Patients; Physiological aspects; Prognosis; Propensity Score; Proportional Hazards Models; Radiation therapy; Rank tests; SEER Program; Statistical models; Surgery; Survival; Survival Rate; Therapeutics, Surgical; White people
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0312455

Head and neck small-cell carcinoma (HNSmCC) is a rare and aggressive cancer with a high tendency for distant metastasis. It is treated with multimodal treatment involving chemotherapy. Occasionally, surgery is performed for the management of locoregional HNSmCC. However, the benefits of surgery in this context have not yet been elucidated. Therefore, in this study, we aimed to investigate whether surgery could improve the survival of patients with HNSmCC. We obtained data from patients with locoregional HNSmCC treated with chemoradiation therapy (CRT) from the Surveillance, Epidemiology, and End Results database. Patients who did and did not undergo surgery were matched using propensity scores. The overall survival (OS) and disease-specific survival (DSS) rates were estimated using the Kaplan-Meier method and tested using the log-rank test. Hazard ratios (HRs) were calculated using the Cox proportional hazard model. The 5-year OS rates of the patients who did and did not undergo surgery were 57.2% and 50.6%, respectively (P = 0.689); the corresponding 5-year DSS rates were 61.0% and 57.5% (P = 0.769). The adjusted HRs for surgery were 0.85 (95% confidence interval [CI]: 0.54-1.33) for OS and 0.87 (95% CI: 0.51-1.49) for DSS. The addition of surgery to CRT did not improve the survival of patients with locoregional HNSmCC.