Survival outcomes in head and neck squamous cell carcinoma of unknown primary: A national cohort study

• DOI: 10.1111/coa.14167
• Publication Date: 2024-05-20T07:53:43Z
• Authors: John C. Hardman; James Constable; Sian Dobbs; Christopher Hogan; Kate Hulse; Shivun Khosla; Kristijonas Milinis; Ben Tudor‐Green; Andrew Williamson; Vinidh Paleri
• Keywords: Neck dissection

Abstract Introduction To investigate factors influencing survival in head and neck squamous cell carcinoma of unknown primary (HNSCCUP). Methods A retrospective observational cohort study was conducted, over 5 years from January 2015, UK Head Neck centres, consecutive adults undergoing 18F‐Fluorodeoxyglucose‐PET‐CT within 3 months diagnosis with metastatic cervical carcinoma. Patients treated as HNSCCUP underwent analysis, stratified by dissection and/or radiotherapy to the ipsilateral neck, HPV status. Results Data were received 57 centres for 965 patients, whom 482 started treatment (65.7% HPV‐positive, n = 282/429). Five‐year overall (OS) HPV‐positive patients 85.0% (95% CI 78.4–92.3) 43.5% 32.9–57.5) HPV‐negative. HPV‐negative status associated worse OS, disease‐free (DFS), disease‐specific (DSS) (all p < .0001 on log‐rank test) but not local control (LC) ( .16). Unilateral disease surgery alone significantly DFS .0001) LC compared or combined modalities (5‐year DFS: 24.9%, 82.3% 94.3%; 5‐year LC: 41.8%, 98.8% 98.6%). OS different .017) estimate unavailable, 93.3% 96.6%, respectively). Small numbers bilateral precluded meaningful sub‐group analysis. Conclusions is variable management outcomes HNSCCUP. variably poorer when managed alone. The impact diagnostic oropharyngeal site emergence, functional unestablished.