HPV status in unknown primary head and neck cancer: Prognosis and treatment outcomes

The Laryngoscope
Shayan CheraghlouBenjamin L Judson

Abstract

Approximately 3% to 9% of head and neck cancer presents with a metastatic node and no identifiable primary tumor. These cases of head and neck carcinoma of unknown primary (HNCUP) present a therapeutic challenge. Therapy of this disease varies based on factors such as institutional, surgeon, and patient preference. Evidence demonstrating the outcomes associated with these therapies for HNCUP is limited, and among the available series, the tumor human papillomavirus (HPV) status is often ignored. Treatment deintensification has been proposed for a subset of these patients. We aim to evaluate the treatment-related outcomes for HPV-associated and HPV-negative HNCUP. A retrospective study of 978 adult HNCUP diagnosed from 2010 to 2013 in the NCDB was conducted. Multivariate Cox survival regressions as well as univariate Kaplan-Meier analyses were conducted. Patients with HPV-associated disease had superior survival, with a 3-year survival of 94.8% (standard error [SE]: 1.0), compared with 80.3% (SE: 2.9) among those with HPV-negative disease. Among HPV-negative patients with clinical nodal classification (cN)2/cN3 disease, treatment with definitive radiotherapy alone compared to definitive chemoradiotherapy was associated with dimi...Continue Reading

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Citations

Jun 14, 2019·JAMA Otolaryngology-- Head & Neck Surgery·Sina J TorabiBenjamin L Judson
Oct 8, 2020·Current Treatment Options in Oncology·Jennifer Moy, Ryan Li
Sep 6, 2020·Auris, Nasus, Larynx·Ichiro Ota, Tadashi Kitahara
Mar 19, 2021·The Laryngoscope·Robert BoekerAnnekatrin Coordes
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Feb 7, 2022·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Ping WangQiao Qiao

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