Detection and Oncologic Outcomes of Head and Neck Squamous Cell Carcinoma of Unknown Primary Origin

Background/Aim: To assess factors that predict detection of tumors and oncologic outcomes in head and neck squamous cell carcinoma of unknown primary (SCCUP). Patients and Methods: This was a retrospective cohort study at a single tertiary care institution. Results: The primary site was detected at...

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Bibliographic Details
Published in:Anticancer research 2020-08, Vol.40 (8), p.4207-4214
Main Authors: LEE, MAXWELL Y., FOWLER, NICOLE, ADELSTEIN, DAVID, KOYFMAN, SHLOMO, PRENDES, BRANDON, BURKEY, BRIAN B.
Format: Article
Language:English
Subjects:
Anesthesia
Chemoradiotherapy
Head & neck cancer
Human papillomavirus
Larynx
Medical prognosis
Nasopharynx
Oral cavity
Squamous cell carcinoma
Tumors
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Summary:Background/Aim: To assess factors that predict detection of tumors and oncologic outcomes in head and neck squamous cell carcinoma of unknown primary (SCCUP). Patients and Methods: This was a retrospective cohort study at a single tertiary care institution. Results: The primary site was detected at examination under anesthesia (EUA) in 92 (51.1%) patients. The primary site was detected by directed biopsies in 60 (65%), palatine tonsillectomy in 28 (30.4%), and lingual tonsillectomy in 4 patients (4.3%). Four of eight lingual tonsillectomies were positive (50%). Primary locations included: palatine tonsils (51, 28.3%), base of tongue (37, 20.6%), larynx (4, 2.2%), oral cavity (3, 1.67%) and nasopharynx (1, 0.6%). Human papillomavirus (HPV) positive status (HR=0.26, p=0.004) and treatment with chemoradiation (CRT) (HR=0.38, p=0.004) were associated with better disease free survival (DFS). Conclusion: A primary site was located after aggressive investigation in approximately half of the patients. More research is warranted towards the use of lingual tonsillectomy. Predictors of favorable prognosis included HPV positive status and treatment with CRT.
ISSN:0250-7005
1791-7530
DOI:10.21873/anticanres.14421