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Factors Influencing the Outcome of Head and Neck Cancer of Unknown Primary (HNCUP)

Background: This study on patients with head and neck cancer of unknown primary (HNCUP) assesses the impact of surgical and non-surgical treatment modalities and the tumour biology on the oncological outcome. Methods: A total of 80 patients with HNCUP (UICC I–IV) were treated with simultaneous neck...

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Autores principales: Balk, Matthias, Rupp, Robin, Mantsopoulos, Konstantinos, Sievert, Matti, Gostian, Magdalena, Allner, Moritz, Grundtner, Philipp, Eckstein, Markus, Iro, Heinrich, Hecht, Markus, Gostian, Antoniu-Oreste
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9143827/
https://www.ncbi.nlm.nih.gov/pubmed/35628814
http://dx.doi.org/10.3390/jcm11102689
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author Balk, Matthias
Rupp, Robin
Mantsopoulos, Konstantinos
Sievert, Matti
Gostian, Magdalena
Allner, Moritz
Grundtner, Philipp
Eckstein, Markus
Iro, Heinrich
Hecht, Markus
Gostian, Antoniu-Oreste
author_facet Balk, Matthias
Rupp, Robin
Mantsopoulos, Konstantinos
Sievert, Matti
Gostian, Magdalena
Allner, Moritz
Grundtner, Philipp
Eckstein, Markus
Iro, Heinrich
Hecht, Markus
Gostian, Antoniu-Oreste
author_sort Balk, Matthias
collection PubMed
description Background: This study on patients with head and neck cancer of unknown primary (HNCUP) assesses the impact of surgical and non-surgical treatment modalities and the tumour biology on the oncological outcome. Methods: A total of 80 patients with HNCUP (UICC I–IV) were treated with simultaneous neck dissection followed by adjuvant therapy, between 1 January 2007 and 31 March 2020. As the primary objective, the influence of treatment modalities on the overall survival (OS), the disease-specific survival (DSS) and the progression-free survival (PFS) were analysed in terms of cox regression and recursive partitioning. The tumour biology served as secondary objectives. Results: The 5-year OS for the entire cohort was 67.7%, (95% CI: 54.2–81.2%), the 5-year DSS was 82.3% (72.1–92.5%) and the 5-year PFS was 72.8% (61.8–83.8%). Cox regression revealed that patients undergoing adjuvant radiotherapy only had a four times higher risk to die compared to patients receiving chemoradiation therapy (HR = 4.45 (1.40; 14.17), p = 0.012). The development of distant metastases had a significantly negative impact on OS (HR = 8.24 (3.21–21.15), p < 0.001) and DSS (HR = 23.79 (6.32–89.56), p < 0.001). Recursive portioning underlined the negative influence of distant metastases on OS (3.2-fold increase in death probability) and DSS (4.3-fold increase in death probability), while an UICC stage of IVb increased the risk for further progression of the disease by a factor of 2. Conclusions: The presence of distant metastases as well as adjuvant treatment with radiation without concomitant chemotherapy, were among others, significant predictors for the overall survival of HNCUP patients, with distant metastases being the most significant predictor.
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spelling pubmed-91438272022-05-29 Factors Influencing the Outcome of Head and Neck Cancer of Unknown Primary (HNCUP) Balk, Matthias Rupp, Robin Mantsopoulos, Konstantinos Sievert, Matti Gostian, Magdalena Allner, Moritz Grundtner, Philipp Eckstein, Markus Iro, Heinrich Hecht, Markus Gostian, Antoniu-Oreste J Clin Med Article Background: This study on patients with head and neck cancer of unknown primary (HNCUP) assesses the impact of surgical and non-surgical treatment modalities and the tumour biology on the oncological outcome. Methods: A total of 80 patients with HNCUP (UICC I–IV) were treated with simultaneous neck dissection followed by adjuvant therapy, between 1 January 2007 and 31 March 2020. As the primary objective, the influence of treatment modalities on the overall survival (OS), the disease-specific survival (DSS) and the progression-free survival (PFS) were analysed in terms of cox regression and recursive partitioning. The tumour biology served as secondary objectives. Results: The 5-year OS for the entire cohort was 67.7%, (95% CI: 54.2–81.2%), the 5-year DSS was 82.3% (72.1–92.5%) and the 5-year PFS was 72.8% (61.8–83.8%). Cox regression revealed that patients undergoing adjuvant radiotherapy only had a four times higher risk to die compared to patients receiving chemoradiation therapy (HR = 4.45 (1.40; 14.17), p = 0.012). The development of distant metastases had a significantly negative impact on OS (HR = 8.24 (3.21–21.15), p < 0.001) and DSS (HR = 23.79 (6.32–89.56), p < 0.001). Recursive portioning underlined the negative influence of distant metastases on OS (3.2-fold increase in death probability) and DSS (4.3-fold increase in death probability), while an UICC stage of IVb increased the risk for further progression of the disease by a factor of 2. Conclusions: The presence of distant metastases as well as adjuvant treatment with radiation without concomitant chemotherapy, were among others, significant predictors for the overall survival of HNCUP patients, with distant metastases being the most significant predictor. MDPI 2022-05-10 /pmc/articles/PMC9143827/ /pubmed/35628814 http://dx.doi.org/10.3390/jcm11102689 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Balk, Matthias
Rupp, Robin
Mantsopoulos, Konstantinos
Sievert, Matti
Gostian, Magdalena
Allner, Moritz
Grundtner, Philipp
Eckstein, Markus
Iro, Heinrich
Hecht, Markus
Gostian, Antoniu-Oreste
Factors Influencing the Outcome of Head and Neck Cancer of Unknown Primary (HNCUP)
title Factors Influencing the Outcome of Head and Neck Cancer of Unknown Primary (HNCUP)
title_full Factors Influencing the Outcome of Head and Neck Cancer of Unknown Primary (HNCUP)
title_fullStr Factors Influencing the Outcome of Head and Neck Cancer of Unknown Primary (HNCUP)
title_full_unstemmed Factors Influencing the Outcome of Head and Neck Cancer of Unknown Primary (HNCUP)
title_short Factors Influencing the Outcome of Head and Neck Cancer of Unknown Primary (HNCUP)
title_sort factors influencing the outcome of head and neck cancer of unknown primary (hncup)
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9143827/
https://www.ncbi.nlm.nih.gov/pubmed/35628814
http://dx.doi.org/10.3390/jcm11102689
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