Occult Primary Head and Neck Squamous Cell Carcinoma: Utility of Discovering Primary Lesions
Identifieur interne : 001D95 ( Main/Exploration ); précédent : 001D94; suivant : 001D96Occult Primary Head and Neck Squamous Cell Carcinoma: Utility of Discovering Primary Lesions
Auteurs : Kara S. Davis [États-Unis] ; J. Kenneth Byrd [États-Unis] ; Vikas Mehta [États-Unis] ; Simon I. Chiosea [États-Unis] ; Seungwon Kim [États-Unis] ; Robert L. Ferris [États-Unis] ; Jonas T. Johnson [États-Unis] ; Umamaheswar Duvvuri [États-Unis]Source :
- Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [ 0194-5998 ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Carcinome épidermoïde (), Carcinome épidermoïde (anatomopathologie), Carcinome épidermoïde (diagnostic), Carcinome épidermoïde (virologie), Femelle, Humains, Mâle, Métastases d'origine inconnue (), Métastases d'origine inconnue (anatomopathologie), Métastases d'origine inconnue (diagnostic), Métastases d'origine inconnue (virologie), Papillomaviridae (isolement et purification), Stade de la tumeur, Taux de survie, Tumeurs de la tête et du cou (), Tumeurs de la tête et du cou (anatomopathologie), Tumeurs de la tête et du cou (diagnostic), Tumeurs de la tête et du cou (virologie), Études rétrospectives.
- MESH :
- anatomopathologie : Carcinome épidermoïde, Métastases d'origine inconnue, Tumeurs de la tête et du cou.
- diagnostic : Carcinome épidermoïde, Métastases d'origine inconnue, Tumeurs de la tête et du cou.
- isolement et purification : Papillomaviridae.
- virologie : Carcinome épidermoïde, Métastases d'origine inconnue, Tumeurs de la tête et du cou.
- Adulte d'âge moyen, Carcinome épidermoïde, Femelle, Humains, Mâle, Métastases d'origine inconnue, Stade de la tumeur, Taux de survie, Tumeurs de la tête et du cou, Études rétrospectives.
English descriptors
- KwdEn :
- Carcinoma, Squamous Cell (diagnosis), Carcinoma, Squamous Cell (pathology), Carcinoma, Squamous Cell (surgery), Carcinoma, Squamous Cell (virology), Female, Head and Neck Neoplasms (diagnosis), Head and Neck Neoplasms (pathology), Head and Neck Neoplasms (surgery), Head and Neck Neoplasms (virology), Humans, Male, Middle Aged, Neoplasm Staging, Neoplasms, Unknown Primary (diagnosis), Neoplasms, Unknown Primary (pathology), Neoplasms, Unknown Primary (surgery), Neoplasms, Unknown Primary (virology), Papillomaviridae (isolation & purification), Retrospective Studies, Survival Rate.
- MESH :
- diagnosis : Carcinoma, Squamous Cell, Head and Neck Neoplasms, Neoplasms, Unknown Primary.
- isolation & purification : Papillomaviridae.
- pathology : Carcinoma, Squamous Cell, Head and Neck Neoplasms, Neoplasms, Unknown Primary.
- surgery : Carcinoma, Squamous Cell, Head and Neck Neoplasms, Neoplasms, Unknown Primary.
- virology : Carcinoma, Squamous Cell, Head and Neck Neoplasms, Neoplasms, Unknown Primary.
- Female, Humans, Male, Middle Aged, Neoplasm Staging, Retrospective Studies, Survival Rate.
Abstract
Cancer of an unknown primary (CUP) squamous cell carcinoma metastatic to cervical lymph nodes is a challenging problem for the treating physician. Our aim is to determine if identification of the primary tumor is associated with improved oncologic outcomes and/or tumor characteristics including human papilloma virus (HPV) status.
Retrospective, matched-pairs analysis contrasting 2 cohorts based upon discovery of primary lesion.
Tertiary teaching hospital.
Records of 136 patients initially diagnosed as carcinoma of unknown primary were retrospectively reviewed (1980–2010) and divided into 2 cohorts based on discovery of the primary lesion. Primary outcome measures were overall survival and time to recurrence according to Kaplan-Meier analysis. A nested subset of 22 patients in which the primary was discovered were matched to 22 patients remaining undiscovered according to nodal stage and age.
Discovered lesions were more likely to exhibit HPV positivity (
HPV positivity is associated with discovery of the primary tumor. Discovery of the primary lesion is associated with improved overall survival, cause-specific survival, and disease-free survival in patients initially presenting as CUP in matched-pair and cohort comparison analyses.
Url:
DOI: 10.1177/0194599814533494
PubMed: 24812081
PubMed Central: 4604041
Affiliations:
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Le document en format XML
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Davis</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology–Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Otolaryngology–Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Byrd, J Kenneth" sort="Byrd, J Kenneth" uniqKey="Byrd J" first="J. Kenneth" last="Byrd">J. Kenneth Byrd</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology–Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Otolaryngology–Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Mehta, Vikas" sort="Mehta, Vikas" uniqKey="Mehta V" first="Vikas" last="Mehta">Vikas Mehta</name><affiliation wicri:level="2"><nlm:aff id="A2">Department of Otolaryngology–Head and Neck Surgery, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Otolaryngology–Head and Neck Surgery, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana</wicri:regionArea><placeName><region type="state">Louisiane</region></placeName></affiliation></author><author><name sortKey="Chiosea, Simon I" sort="Chiosea, Simon I" uniqKey="Chiosea S" first="Simon I." last="Chiosea">Simon I. Chiosea</name><affiliation wicri:level="2"><nlm:aff id="A3">Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Kim, Seungwon" sort="Kim, Seungwon" uniqKey="Kim S" first="Seungwon" last="Kim">Seungwon Kim</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology–Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Otolaryngology–Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Ferris, Robert L" sort="Ferris, Robert L" uniqKey="Ferris R" first="Robert L." last="Ferris">Robert L. Ferris</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology–Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Otolaryngology–Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Johnson, Jonas T" sort="Johnson, Jonas T" uniqKey="Johnson J" first="Jonas T." last="Johnson">Jonas T. Johnson</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology–Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Otolaryngology–Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Duvvuri, Umamaheswar" sort="Duvvuri, Umamaheswar" uniqKey="Duvvuri U" first="Umamaheswar" last="Duvvuri">Umamaheswar Duvvuri</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology–Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Otolaryngology–Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="A4">VA Pittsburgh Health System, Pittsburgh, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>VA Pittsburgh Health System, Pittsburgh, Pennsylvania</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author></analytic><series><title level="j">Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery</title><idno type="ISSN">0194-5998</idno><idno type="eISSN">1097-6817</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Carcinoma, Squamous Cell (diagnosis)</term><term>Carcinoma, Squamous Cell (pathology)</term><term>Carcinoma, Squamous Cell (surgery)</term><term>Carcinoma, Squamous Cell (virology)</term><term>Female</term><term>Head and Neck Neoplasms (diagnosis)</term><term>Head and Neck Neoplasms (pathology)</term><term>Head and Neck Neoplasms (surgery)</term><term>Head and Neck Neoplasms (virology)</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Neoplasm Staging</term><term>Neoplasms, Unknown Primary (diagnosis)</term><term>Neoplasms, Unknown Primary (pathology)</term><term>Neoplasms, Unknown Primary (surgery)</term><term>Neoplasms, Unknown Primary (virology)</term><term>Papillomaviridae (isolation & purification)</term><term>Retrospective Studies</term><term>Survival Rate</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Carcinome épidermoïde ()</term><term>Carcinome épidermoïde (anatomopathologie)</term><term>Carcinome épidermoïde (diagnostic)</term><term>Carcinome épidermoïde (virologie)</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Métastases d'origine inconnue ()</term><term>Métastases d'origine inconnue (anatomopathologie)</term><term>Métastases d'origine inconnue (diagnostic)</term><term>Métastases d'origine inconnue (virologie)</term><term>Papillomaviridae (isolement et purification)</term><term>Stade de la tumeur</term><term>Taux de survie</term><term>Tumeurs de la tête et du cou ()</term><term>Tumeurs de la tête et du cou (anatomopathologie)</term><term>Tumeurs de la tête et du cou (diagnostic)</term><term>Tumeurs de la tête et du cou (virologie)</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Carcinome épidermoïde</term><term>Métastases d'origine inconnue</term><term>Tumeurs de la tête et du cou</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Carcinoma, Squamous Cell</term><term>Head and Neck Neoplasms</term><term>Neoplasms, Unknown Primary</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Carcinome épidermoïde</term><term>Métastases d'origine inconnue</term><term>Tumeurs de la tête et du cou</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Papillomaviridae</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Papillomaviridae</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Carcinoma, Squamous Cell</term><term>Head and Neck Neoplasms</term><term>Neoplasms, Unknown Primary</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Carcinoma, Squamous Cell</term><term>Head and Neck Neoplasms</term><term>Neoplasms, Unknown Primary</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Carcinome épidermoïde</term><term>Métastases d'origine inconnue</term><term>Tumeurs de la tête et du cou</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Carcinoma, Squamous Cell</term><term>Head and Neck Neoplasms</term><term>Neoplasms, Unknown Primary</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Neoplasm Staging</term><term>Retrospective Studies</term><term>Survival Rate</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Carcinome épidermoïde</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Métastases d'origine inconnue</term><term>Stade de la tumeur</term><term>Taux de survie</term><term>Tumeurs de la tête et du cou</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">Cancer of an unknown primary (CUP) squamous cell carcinoma metastatic to cervical lymph nodes is a challenging problem for the treating physician. Our aim is to determine if identification of the primary tumor is associated with improved oncologic outcomes and/or tumor characteristics including human papilloma virus (HPV) status.</p></sec><sec id="S2"><title>Study Design</title><p id="P2">Retrospective, matched-pairs analysis contrasting 2 cohorts based upon discovery of primary lesion.</p></sec><sec id="S3"><title>Setting</title><p id="P3">Tertiary teaching hospital.</p></sec><sec id="S4"><title>Subjects and Methods</title><p id="P4">Records of 136 patients initially diagnosed as carcinoma of unknown primary were retrospectively reviewed (1980–2010) and divided into 2 cohorts based on discovery of the primary lesion. Primary outcome measures were overall survival and time to recurrence according to Kaplan-Meier analysis. A nested subset of 22 patients in which the primary was discovered were matched to 22 patients remaining undiscovered according to nodal stage and age.</p></sec><sec id="S5"><title>Results</title><p id="P5">Discovered lesions were more likely to exhibit HPV positivity (<italic>P</italic> <.001). Matched-pairs analyses demonstrated that discovery of the primary was associated with better overall survival (HR = 0.125; 95% confidence interval [CI], 0.019–0.822; <italic>P</italic> = .030). Discovery of the primary was associated with improved cause-specific survival (HR = 0.142; 95% CI, 0.021–0.93; <italic>P</italic> = .0418) and disease-free survival (HR = 0.25; 95% CI, 0.069–0.91; <italic>P</italic> = .03).</p></sec><sec id="S6"><title>Conclusion</title><p id="P6">HPV positivity is associated with discovery of the primary tumor. Discovery of the primary lesion is associated with improved overall survival, cause-specific survival, and disease-free survival in patients initially presenting as CUP in matched-pair and cohort comparison analyses.</p></sec></div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Louisiane</li><li>Pennsylvanie</li></region></list><tree><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Davis, Kara S" sort="Davis, Kara S" uniqKey="Davis K" first="Kara S." last="Davis">Kara S. Davis</name></region><name sortKey="Byrd, J Kenneth" sort="Byrd, J Kenneth" uniqKey="Byrd J" first="J. Kenneth" last="Byrd">J. Kenneth Byrd</name><name sortKey="Chiosea, Simon I" sort="Chiosea, Simon I" uniqKey="Chiosea S" first="Simon I." last="Chiosea">Simon I. Chiosea</name><name sortKey="Duvvuri, Umamaheswar" sort="Duvvuri, Umamaheswar" uniqKey="Duvvuri U" first="Umamaheswar" last="Duvvuri">Umamaheswar Duvvuri</name><name sortKey="Duvvuri, Umamaheswar" sort="Duvvuri, Umamaheswar" uniqKey="Duvvuri U" first="Umamaheswar" last="Duvvuri">Umamaheswar Duvvuri</name><name sortKey="Ferris, Robert L" sort="Ferris, Robert L" uniqKey="Ferris R" first="Robert L." last="Ferris">Robert L. Ferris</name><name sortKey="Johnson, Jonas T" sort="Johnson, Jonas T" uniqKey="Johnson J" first="Jonas T." last="Johnson">Jonas T. Johnson</name><name sortKey="Kim, Seungwon" sort="Kim, Seungwon" uniqKey="Kim S" first="Seungwon" last="Kim">Seungwon Kim</name><name sortKey="Mehta, Vikas" sort="Mehta, Vikas" uniqKey="Mehta V" first="Vikas" last="Mehta">Vikas Mehta</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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