Swedish National Multicenter Study on Head and Neck Cancer of Unknown Primary: Prognostic Factors and Impact of Treatment on Survival.

Autor: Axelsson L; Department of Otorhinolaryngology, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden.; Department of Otorhinolaryngology - Head and Neck Surgery, Sahlgrenska University Hospital, Goteborg, Sweden., Holmberg E; Regional Cancer Center in Western Sweden, Gothenburg, Sweden.; Department of Oncology, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden., Nyman J; Department of Oncology, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden., Högmo A; Department of Otorhinolaryngology - Head and Neck Surgery, Karolinska University Hospital, Stockholm, Sweden., Sjödin H; Department of Oncology, Karolinska University Hospital, Stockholm, Sweden., Gebre-Medhin M; Department of Oncology, Lund University Hospital, Lund, Skåne, Sweden., von Beckerath M; Department of Otorhinolaryngology - Head and Neck Surgery, Örebro University Hospital, Örebro, Sweden., Ekberg T; Department of Otorhinolaryngology - Head and Neck Surgery, Uppsala University Hospital, Uppsala, Sweden., Farnebo L; Department of Otorhinolaryngology - Head and Neck Surgery, Linköping University Hospital, Linkoping, Sweden., Talani C; Department of Oncology, Linköping University Hospital, Linkoping, Sweden., Spak LN; Department of Otorhinolaryngology - Head and Neck Surgery, Norrlands University Hospital, Umea, Sweden., Notstam I; Department of Otorhinolaryngology, County Hospital Sundsvall-Harnosand, Sundsvall, Sweden., Hammerlid E; Department of Otorhinolaryngology, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden.; Department of Otorhinolaryngology - Head and Neck Surgery, Sahlgrenska University Hospital, Goteborg, Sweden.
Jazyk: angličtina
Zdroj: International archives of otorhinolaryngology [Int Arch Otorhinolaryngol] 2021 Jul; Vol. 25 (3), pp. e433-e442. Date of Electronic Publication: 2020 Sep 30.
DOI: 10.1055/s-0040-1712106
Abstrakt: Introduction  Head and neck cancer of unknown primary (HNCUP) is a rare condition whose prognostic factors that are significant for survival vary between studies. No randomized treatment study has been performed thus far, and the optimal treatment is not established. Objective  The present study aimed to explore various prognostic factors and compare the two main treatments for HNCUP: neck dissection and (chemo) radiation vs primary (chemo) radiation. Methods  A national multicenter study was performed with data from the Swedish Head and Neck Cancer Register (SweHNCR) and from the patients' medical records from 2008 to 2012. Results  Two-hundred and sixty HNCUP patients were included. The tumors were HPV-positive in 80%. The overall 5-year survival rate of patients treated with curative intent was 71%. Age ( p  < 0.001), performance status ( p = 0.036), and N stage ( p = 0.046) were significant factors for overall survival according to the multivariable analysis. Treatment with neck dissection and (chemo) radiation (122 patients) gave an overall 5-year survival of 73%, and treatment with primary (chemo) radiation (87 patients) gave an overall 5-year survival of 71%, with no significant difference in overall or disease-free survival between the 2 groups. Conclusions  Age, performance status, and N stage were significant prognostic factors. Treatment with neck dissection and (chemo) radiation and primary (chemo) radiation gave similar survival outcomes. A randomized treatment study that includes quality of life is needed to establish the optimal treatment.
Competing Interests: Conflict of Interest Dr. Axelsson reports grants from The Foundation ACTA Oto-Laryngologica, The Health and Medical Care Committee of the Regional Executive Board, Region VästraGötaland, and from The ALF project funding for clinically oriented medical research projects, during the conduct of the study. Dr. Hammerlid reports grants from The Health and Medical Care Committee of the Regional Executive Board, Region VästraGötaland, and from The ALF project funding for clinically oriented medical research projects, during the conduct of the study.
(Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)
Databáze: MEDLINE
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