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Small cell carcinoma of the head and neck: A comparative study by primary site based on population data
Author(s) -
Kuan Edward C.,
Alonso Jose E.,
Tajudeen Bobby A.,
Arshi Armin,
MallenSt. Clair Jon,
St. John Maie A.
Publication year - 2017
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26406
Subject(s) - medicine , incidence (geometry) , head and neck , larynx , radiation therapy , population , head and neck squamous cell carcinoma , malignancy , head and neck cancer , retrospective cohort study , cohort , radiology , oncology , surgery , geometry , environmental health , mathematics
Objectives/Hypothesis Small cell carcinoma (SmCC) of the head and neck is an extremely rare neuroendocrine malignancy. In this study, we describe the incidence and determinants of survival of patients with SmCC of the head and neck between the years of 1973 and 2012 using the Surveillance, Epidemiology, and End Results database as differed by primary site. Study Design Retrospective, population‐based cohort study. Methods A total of 237 cases of SmCC of the head and neck were identified, which was divided into sinonasal primaries (n = 82) and all other head and neck primaries (n = 155). Clinicopathologic and epidemiologic variables were analyzed as predictors of overall survival (OS) and disease‐specific survival (DSS) based on the Kaplan‐Meier method. Results More than half of sinonasal primaries presented with Kadish stage C or D. On multivariate analysis, surgery was the only independent predictor of improved DSS ( P = .008) for sinonasal primaries; in contrast, radiation therapy was a favorable prognosticator for OS ( P = .007) and DSS ( P = .043) in extrasinonasal sites. Comparison of survival between sinonasal primaries and all other sites demonstrated that sinonasal SmCC had uniformly better OS ( P = .002) and DSS ( P = .006). Conclusions SmCC in the head and neck remains rare, and sinonasal primaries appear to have improved survival compared to other sites. Based on these results, optimal treatment for sinonasal SmCC appears to be surgical therapy, whereas radiation therapy is the preferred treatment for SmCC of other primary sites, particularly the larynx. Level of Evidence 4. Laryngoscope , 127:1785–1790, 2017