Prognostic Factors in Head and Neck Mucoepidermoid Carcinoma

Abstract 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.

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Prognosis in Head and Neck Cancer: Importance of Nutritional and Biological Inflammatory Status

Otolaryngology ◽

10.1177/01945998211004592 ◽

2021 ◽

pp. 019459982110045

Author(s):

Nicolas Saroul ◽

Mathilde Puechmaille ◽

Céline Lambert ◽

Achraf Sayed Hassan ◽

Julian Biau ◽

...

Keyword(s):

Head And Neck Cancer ◽

Prognostic Factors ◽

Inflammatory Response ◽

Nutritional Status ◽

Head And Neck ◽

Neck Cancer ◽

Risk Index ◽

Nutritional Risk ◽

Inflammatory Status ◽

Nutritional Risk Index

Objectives To determine the importance of nutritional status, social status, and inflammatory status in the prognosis of head and neck cancer. Study Design Single-center retrospective study of prospectively collected data. Setting Tertiary referral center. Methods Ninety-two consecutive patients newly diagnosed for cancer of the upper aerodigestive tract without metastases were assessed at time of diagnosis for several prognostic factors. Nutritional status was assessed by the nutritional risk index, social status by the EPICES score, and inflammatory status by the systemic inflammatory response index. The primary endpoint was overall survival. Results In multivariable analysis, the main prognostic factors were the TNM classification (hazard ratio [HR] = 3.34, P = .002, for stage T3-4), malnutrition as assessed by the nutritional risk index (HR = 3.64, P = .008, for severe malnutrition), and a systemic inflammatory response index score ≥1.6 (HR = 3.32, P = .02). Social deprivation was not a prognostic factor. Conclusion Prognosis in head and neck cancer is multifactorial; however, malnutrition and inflammation are important factors that are potentially reversible by early intervention.

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Prognostic factors in recurrent or metastatic squamous cell carcinoma of the head and neck

Head & Neck ◽

10.1002/hed.25636 ◽

2019 ◽

Vol 41 (6) ◽

pp. 1895-1902 ◽

Cited By ~ 1

Author(s):

Aurora Mirabile ◽

Rosalba Miceli ◽

Rosa Gioia Calderone ◽

Laura Locati ◽

Paolo Bossi ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Prognostic Factors ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Metastatic Squamous Cell Carcinoma

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Prognostic Factors and Oncological Outcomes of 122 Head and Neck Soft Tissue Sarcoma Patients Treated at a Single Institution

Annals of Surgical Oncology ◽

10.1245/s10434-014-3870-8 ◽

2014 ◽

Vol 22 (1) ◽

pp. 248-255 ◽

Cited By ~ 20

Author(s):

Jin Taek Park ◽

Jong-Lyel Roh ◽

Seon-Ok Kim ◽

Kyung-Ja Cho ◽

Seung-Ho Choi ◽

...

Keyword(s):

Prognostic Factors ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Head And Neck ◽

Single Institution ◽

Oncological Outcomes

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Localized head and neck lymphomas — Analysis of prognostic factors and treatment outcome

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/0360-3016(91)90631-d ◽

1991 ◽

Vol 21 ◽

pp. 225

Author(s):

A. Bezjak ◽

M.K. Gospodarowicz ◽

S.B. Sutcliffe ◽

R.M. Clark

Keyword(s):

Treatment Outcome ◽

Prognostic Factors ◽

Head And Neck

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Soft tissue sarcomas of the head and neck: outcome and prognostic factors

International Journal of Clinical Oncology ◽

10.1007/pl00012048 ◽

2000 ◽

Vol 5 (4) ◽

pp. 269-275

Author(s):

T. Shouman ◽

M. Gameel ◽

A. Attia ◽

S. A. El-Aziz ◽

N. Mohamed

Keyword(s):

Prognostic Factors ◽

Soft Tissue ◽

Head And Neck ◽

Soft Tissue Sarcomas

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Sarcomas of the head and neck. Prognostic factors and treatment strategies

Cancer ◽

10.1002/1097-0142(19920701)70:1<169::aid-cncr2820700127>3.0.co;2-f ◽

1992 ◽

Vol 70 (1) ◽

pp. 169-177 ◽

Cited By ~ 137

Author(s):

Luir M. Tran ◽

Rufus Mark ◽

Robert Meier ◽

Thomas C. Calcaterra ◽

Robert G. Parker

Keyword(s):

Prognostic Factors ◽

Head And Neck ◽

Treatment Strategies

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Adjuvant radiotherapy plus systemic chemotherapy in resected head and neck mucosal melanoma.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18042 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18042-e18042

Author(s):

Rong Duan ◽

Bixia Tang ◽

Zhihong Chi ◽

Chuanliang Cui ◽

Bin Lian ◽

...

Keyword(s):

Prognostic Factors ◽

Head And Neck ◽

Distant Metastasis ◽

Adjuvant Radiotherapy ◽

Postoperative Radiotherapy ◽

Local Relapse ◽

Mucosal Melanoma ◽

Uicc Stage ◽

Free Survival ◽

Cox Analysis

e18042 Background: The median over survival (OS) of resected head and neck mucosal melanoma (HNMM) is 49.0 months. About 65% of patients experience local recurrence or distant metastasis after surgery. Therefore, adjuvant therapy is critical to improve the poor prognosis. Methods: Data regarding HNMMs with radical surgery (stage III-IVa, AJCC HNMM 8th version) between September 1, 2006 and February 28, 2020 at Peking University Cancer Hospital was collected retrospectively. Postoperative radiotherapy was usually prescribed as GTV 60-70Gy/CTV 60Gy/30f. Patients were divided into four groups by the adjuvant regimens: radiotherapy+chemotherapy (RC), chemotherapy (C), radiotherapy (R) and observation (O). Results: In total, 368 patients were enrolled, including 104 RC,114 C, 53 R, 97 O, respectively. After median follow-up of 63.9 mo (range: 0.9-146.7), the median local relapse-free survival (LRFS) was 10.1 mo (95%CI: 6.7-13.6) in the O group, as compared with 65.9 mo (95%CI: 31.7-100.1, P＜0.001) in the R group, 75.6 mo (95%CI: 50.1-101.0, P＜0.001) in the C group, and 84.6 mo (95%CI: 48.5-120.8, P＜0.001) in the RC group. The median distant metastasis-free survival (DMFS) was 13.7 mo (95%CI: 8.0-19.5) in the O group, 15.3 mo (95%CI: 8.7-21.9, P = 0.898) in the R group, as compared with 25.7 mo (95%CI: 14.6-36.8, P = 0.001) in the C group, 49.3 mo (95%CI: 32.6-66.0, P＜0.001) in the RC group. Estimated OS was 36.4 mo (95%CI: 24.0-48.8) in the O group, as compared with 30.8 mo (95%CI: 23.0-38.6, P = 0.733) in the R group, 40.8 mo (95%CI: 34.8-46.8, P = 0.289) in the C group, 58.2 mp (95%CI: 36.4-79.9, P = 0.002) in the RC group. Primary location, age, gender, UICC staging and adjuvant regimens were included for multivariate Cox analysis. With regard to OS, UICC stage and RC were the prognostic factors. With regard to DMFS, UICC stage, RC and C were the prognostic factors. With regard to LRFS, UICC stage, RC, R, C were the prognostic factors. Conclusions: It is the largest study on the role of adjuvant radiotherapy and chemotherapy on HNMM till now. The results demonstrate that postoperative radiotherapy improves LRFS but has no impact on DMFS, while adjuvant radiotherapy plus chemotherapy prolongs OS. It further validates the clinical practice of UICC stage of HNMM, which might shed lights on the study of the whole mucosal melanoma.

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Prognostic Nutritional Index as an independent prognostic factor in locoregionally advanced squamous cell head and neck cancer

ESMO Open ◽

10.1136/esmoopen-2018-000425 ◽

2018 ◽

Vol 3 (6) ◽

pp. e000425 ◽

Cited By ~ 8

Author(s):

Gema Bruixola ◽

Javier Caballero ◽

Federica Papaccio ◽

Angelica Petrillo ◽

Aina Iranzo ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Prognostic Factor ◽

Head And Neck ◽

Squamous Cell ◽

Validation Cohort ◽

Prognostic Nutritional Index ◽

Training Cohort ◽

Lymphocyte Ratio ◽

Nutritional Index

BackgroundLocally advanced head and neck squamous cell carcinoma (LAHNSCC) is a heterogeneous disease in which better predictive and prognostic factors are needed. Apart from TNM stage, both systemic inflammation and poor nutritional status have a negative impact on survival.MethodsWe retrospectively analysed two independent cohorts of a total of 145 patients with LAHNSCC treated with induction chemotherapy followed by concurrent chemoradiotherapy at two different academic institutions. Full clinical data, including the Prognostic Nutritional Index (PNI), neutrophil to lymphocyte ratio and derived neutrophil to lymphocyte ratio, were analysed in a training cohort of 50 patients. Receiver operating characteristic curve analysis was used to establish optimal cut-off. Univariate and multivariate analyses of prognostic factors for overall survival (OS) were performed. Independent predictors of OS identified in multivariate analysis were confirmed in a validation cohort of 95 patients.ResultsIn the univariate analysis, low PNI (PNI<45) (p=0.001), large primary tumour (T4) (p=0.044) and advanced lymph node disease (N2b-N3) (p=0.025) were significantly associated with poorer OS in the validation cohort. The independent prognostic factors in the multivariate analysis for OS identified in the training cohort were dRNL (p=0.030) and PNI (p=0.042). In the validation cohort, only the PNI remained as independent prognostic factor (p=0.007).ConclusionsPNI is a readily available, independent prognostic biomarker for OS in LAHNSCC. Adding PNI to tumour staging could improve individual risk stratification of patients with LAHNSCC in future clinical trials.

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