Clinical outcomes for patients presenting with N3 head and neck squamous cell carcinoma: Analysis of the National Cancer Database

Huaising C. Ko, Shuai Chen, Aaron M. Wieland, Menggang Yu, Andrew M. Baschnagel, Gregory K. Hartig, Paul M. Harari, Matthew E. Witek

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background: There is a paucity of data regarding head and neck squamous cell carcinomas (HNSCCs) and N3 nodal disease. Methods: Retrospective analysis of patients with N3 HNSCC identified in the National Cancer Database (NCDB) was performed. Results: We identified 4867 patients with N3 HNSCC treated with primary surgery or chemoradiotherapy (CRT). Propensity-adjusted median survival was 54.2 and 44.8 months for surgery and CRT, respectively (P =.06). Oropharyngeal primary subsite demonstrated a survival advantage with surgery versus CRT with propensity-adjusted median survivals of 86.0 and 61.9 months, respectively (P <.05). Conclusion: Management of N3 HNSCC relies largely on CRT. Patients with N3 nodal disease with nonoropharyngeal primary tumors exhibit 5-year overall survival approaching 30% independent of initial treatment modality. Patients with oropharyngeal primaries exhibit improved outcomes with surgery largely influenced by the human papillomavirus (HPV)-negative subset. These data represent the most comprehensive analysis of N3 HNSCC outcomes and serves as a foundation for future research and clinical management.

Original languageEnglish (US)
Pages (from-to)2159-2170
Number of pages12
JournalHead and Neck
Volume39
Issue number11
DOIs
StatePublished - Nov 1 2017
Externally publishedYes

Keywords

  • head and neck cancer
  • N3 nodal staging
  • National Cancer Database
  • radiation
  • surgery

ASJC Scopus subject areas

  • Otorhinolaryngology

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    Ko, H. C., Chen, S., Wieland, A. M., Yu, M., Baschnagel, A. M., Hartig, G. K., Harari, P. M., & Witek, M. E. (2017). Clinical outcomes for patients presenting with N3 head and neck squamous cell carcinoma: Analysis of the National Cancer Database. Head and Neck, 39(11), 2159-2170. https://doi.org/10.1002/hed.24881