Survival outcomes in head and neck squamous cell carcinoma of unknown primary: A national cohort study
Hardman JC., Constable J., Dobbs S., Hogan C., Hulse K., Khosla S., Milinis K., Tudor-Green B., Williamson A., Paleri V., Asimakopoulos P., Cooper F., Rao P., Davies K., Davies T., Derbyshire S., Gao C., Ike C., Abdelkader M., Hogan C., Spraggs P., Bashyam A., Patel J., Dale O., Brennan L., Puvanendran M., Wong BLK., Ahmed T., Jose J., Molena E., Winter SC., Rudd J., Anderson C., Patel W., Maheshwar A., Devakumar H., Tailor B., Gurunathan R., Donaldson G., Counter P., Tabaksert A., Ton T., Lee CW., Srinivasan R., Qureshi MH., Williams R., Keates N., Jones M., Grey-Still E., Kapoor K., Balasubramanian A., Anorson N., Bowen A., O'Hara J., Lazarova L., Bradish T., Waters A., Pitkin L., Germain S., Prabhu V., Shastri P., Buchanan M., Tikka T., Loroch A., Jeannon JP., Faulkner J., De M., Rodrigues R., Garas G., Hilger A., Myuran T., Low D., Al Omari B., Collins R., Moor J., Williams M., Round A., Chadha A., Olaleye O., Vasanthan R., Bonduelle Q., Hatab S., Shotton J., Caton N., Shah S., Manickavasagam J., Bannon R., Hong EH., Supriya M., Thoppil J., King E., McGaughey A., Sharma N., Nieto H., Snelson D., Nankivell PC., Montgomery J.
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, in UK Head and Neck centres, of consecutive adults undergoing 18F-Fluorodeoxyglucose-PET-CT within 3 months of diagnosis with metastatic cervical squamous cell carcinoma. Patients treated as HNSCCUP underwent survival analysis, stratified by neck dissection and/or radiotherapy to the ipsilateral neck, and by HPV status. Results: Data were received from 57 centres for 965 patients, of whom 482 started treatment for HNSCCUP (65.7% HPV-positive, n = 282/429). Five-year overall survival (OS) for HPV-positive patients was 85.0% (95% CI 78.4–92.3) and 43.5% (95% CI 32.9–57.5) for HPV-negative. HPV-negative status was associated with worse OS, disease-free (DFS), and disease-specific (DSS) survival (all p