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Occult Primary Head and Neck Squamous Cell Carcinoma: Utility of Discovering Primary Lesions.

Identifieur interne : 002072 ( PubMed/Curation ); précédent : 002071; suivant : 002073

Occult 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 :

RBID : pubmed:24812081

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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.

DOI: 10.1177/0194599814533494
PubMed: 24812081

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pubmed:24812081

Le document en format XML

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<term>Male</term>
<term>Middle Aged</term>
<term>Neoplasm Staging</term>
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<term>Neoplasms, Unknown Primary (virology)</term>
<term>Papillomaviridae (isolation & purification)</term>
<term>Retrospective Studies</term>
<term>Survival Rate</term>
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<term>Adulte d'âge moyen</term>
<term>Carcinome épidermoïde ()</term>
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<term>Carcinome épidermoïde (diagnostic)</term>
<term>Carcinome épidermoïde (virologie)</term>
<term>Femelle</term>
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<term>Head and Neck Neoplasms</term>
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<term>Retrospective Studies</term>
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<term>Métastases d'origine inconnue</term>
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<div type="abstract" xml:lang="en">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.</div>
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<Day>14</Day>
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<Month>09</Month>
<Day>18</Day>
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<Day>18</Day>
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<ISSN IssnType="Electronic">1097-6817</ISSN>
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<Month>Aug</Month>
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<Title>Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery</Title>
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<ArticleTitle>Occult Primary Head and Neck Squamous Cell Carcinoma: Utility of Discovering Primary Lesions.</ArticleTitle>
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<AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">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.</AbstractText>
<AbstractText Label="STUDY DESIGN" NlmCategory="METHODS">Retrospective, matched-pairs analysis contrasting 2 cohorts based upon discovery of primary lesion.</AbstractText>
<AbstractText Label="SETTING" NlmCategory="METHODS">Tertiary teaching hospital.</AbstractText>
<AbstractText Label="SUBJECTS AND METHODS" NlmCategory="METHODS">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.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Discovered lesions were more likely to exhibit HPV positivity (P < .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; P = .030). Discovery of the primary was associated with improved cause-specific survival (HR = 0.142; 95% CI, 0.021-0.93; P = .0418) and disease-free survival (HR = 0.25; 95% CI, 0.069-0.91; P = .03).</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">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.</AbstractText>
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<Grant>
<GrantID>UL1 RR024153</GrantID>
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<PMID Version="1">19427557</PMID>
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<MeshHeadingList>
<MeshHeading>
<DescriptorName UI="D002294" MajorTopicYN="N">Carcinoma, Squamous Cell</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName>
<QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName>
<QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
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<MeshHeading>
<DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D006258" MajorTopicYN="N">Head and Neck Neoplasms</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName>
<QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName>
<QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
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<DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
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<MeshHeading>
<DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D009367" MajorTopicYN="N">Neoplasm Staging</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D009382" MajorTopicYN="N">Neoplasms, Unknown Primary</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName>
<QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName>
<QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D027383" MajorTopicYN="N">Papillomaviridae</DescriptorName>
<QualifierName UI="Q000302" MajorTopicYN="N">isolation & purification</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D015996" MajorTopicYN="N">Survival Rate</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<OtherID Source="NLM">NIHMS712083</OtherID>
<OtherID Source="NLM">PMC4604041</OtherID>
<KeywordList Owner="NOTNLM">
<Keyword MajorTopicYN="N">HPV</Keyword>
<Keyword MajorTopicYN="N">base of tongue</Keyword>
<Keyword MajorTopicYN="N">cervical metastases</Keyword>
<Keyword MajorTopicYN="N">human papilloma virus</Keyword>
<Keyword MajorTopicYN="N">oropharyngeal</Keyword>
<Keyword MajorTopicYN="N">oropharyngeal cancer</Keyword>
<Keyword MajorTopicYN="N">squamous cell carcinoma</Keyword>
<Keyword MajorTopicYN="N">tonsil</Keyword>
<Keyword MajorTopicYN="N">unknown primary</Keyword>
<Keyword MajorTopicYN="N">unknown primary tumor</Keyword>
</KeywordList>
<CoiStatement>Umamaheswar Duvvuri, The University of Pittsburgh Medical Center was awarded a Clinical Robotics Research Grant from Intuitive Surgical, Inc. Intuitive Surgical has no direct financial relationship with any of the authors and does not censor any research performed. Dr Duvvuri is the director of this grant.</CoiStatement>
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<Year>2013</Year>
<Month>10</Month>
<Day>25</Day>
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<PubMedPubDate PubStatus="accepted">
<Year>2014</Year>
<Month>04</Month>
<Day>08</Day>
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<Year>2014</Year>
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