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 language | English (US) |
|---|---|
| Pages (from-to) | 2159-2170 |
| Number of pages | 12 |
| Journal | Head and Neck |
| Volume | 39 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 1 2017 |
| Externally published | Yes |
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Keywords
- head and neck cancer
- N3 nodal staging
- National Cancer Database
- radiation
- surgery
ASJC Scopus subject areas
- Otorhinolaryngology
Cite this
Clinical outcomes for patients presenting with N3 head and neck squamous cell carcinoma : Analysis of the National Cancer Database. / Ko, Huaising C.; Chen, Shuai; Wieland, Aaron M.; Yu, Menggang; Baschnagel, Andrew M.; Hartig, Gregory K.; Harari, Paul M.; Witek, Matthew E.
In: Head and Neck, Vol. 39, No. 11, 01.11.2017, p. 2159-2170.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinical outcomes for patients presenting with N3 head and neck squamous cell carcinoma
T2 - Analysis of the National Cancer Database
AU - Ko, Huaising C.
AU - Chen, Shuai
AU - Wieland, Aaron M.
AU - Yu, Menggang
AU - Baschnagel, Andrew M.
AU - Hartig, Gregory K.
AU - Harari, Paul M.
AU - Witek, Matthew E.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - 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.
AB - 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.
KW - head and neck cancer
KW - N3 nodal staging
KW - National Cancer Database
KW - radiation
KW - surgery
UR - http://www.scopus.com/inward/record.url?scp=85031704271&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85031704271&partnerID=8YFLogxK
U2 - 10.1002/hed.24881
DO - 10.1002/hed.24881
M3 - Article
C2 - 28737019
AN - SCOPUS:85031704271
VL - 39
SP - 2159
EP - 2170
JO - Head and Neck Surgery
JF - Head and Neck Surgery
SN - 0148-6403
IS - 11
ER -