Predictors of survival in parotid small cell carcinoma: A study of 344 cases

Objectives/Hypothesis We sought to better characterize patient, tumor, and long‐term survival characteristics of parotid small cell carcinoma (SmCC) with the National Cancer Database (NCDB). Study Design Retrospective database review. Methods We reviewed the NCDB (1998–2012) for all cases of parotid...

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Veröffentlicht in:The Laryngoscope 2016-09, Vol.126 (9), p.2036-2040
Hauptverfasser: Zhan, Kevin Y., Din, Hassieb A., Muus, John S., Nguyen, Shaun A., Lentsch, Eric J.
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container_end_page 2040
container_issue 9
container_start_page 2036
container_title The Laryngoscope
container_volume 126
creator Zhan, Kevin Y.
Din, Hassieb A.
Muus, John S.
Nguyen, Shaun A.
Lentsch, Eric J.
description Objectives/Hypothesis We sought to better characterize patient, tumor, and long‐term survival characteristics of parotid small cell carcinoma (SmCC) with the National Cancer Database (NCDB). Study Design Retrospective database review. Methods We reviewed the NCDB (1998–2012) for all cases of parotid SmCC. Relevant demographic, tumor, and survival variables were extracted and analyzed. Cox multivariate regression was performed to identify prognosticators. Results Out of 30,813 parotid gland cancers in the NCDB, we found 344 cases of parotid SmCC (1.11%). Age at diagnosis ranged from 23 to 91 years (mean = 73 years). Most patients (73.0%) were male. Most tumors were 2 to 4 cm in size (51.4%). Regional metastases were common (50.8% cN+ and 65.1% pN+) and distant metastasis (7.3%) was uncommon. Occult nodes were found in 14.4% of cases. Overall survival at 5 and 10 years was 37% and 20%, respectively. Although numerous variables were found to significantly impact survival on univariate regression analysis, age (hazard ratio [HR]: 1.05, 95% confidence interval [CI]: 1.03‐1.08, P < .001), tumor size of 2 to 4 cm (HR: 2.51, 95% CI: 1.83‐5.11, P = .011), tumors >4 cm (HR: 3.44, 95% CI: 1.63‐7.27) and distant metastasis (HR: 2.06, 95% CI: 1.02‐4.14, P = .043) remained significant prognosticators in our multivariate model. Nodal disease was not a significant risk factor after adjustment (P = .055). Conclusions SmCC is a rare parotid malignancy with a poor prognosis. Regional metastases were common, whereas distant metastases were uncommon. Elective neck treatment should be considered due to the incidence of occult nodal disease. Level of Evidence 4 Laryngoscope, 126:2036–2040, 2016
doi_str_mv 10.1002/lary.25923
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Study Design Retrospective database review. Methods We reviewed the NCDB (1998–2012) for all cases of parotid SmCC. Relevant demographic, tumor, and survival variables were extracted and analyzed. Cox multivariate regression was performed to identify prognosticators. Results Out of 30,813 parotid gland cancers in the NCDB, we found 344 cases of parotid SmCC (1.11%). Age at diagnosis ranged from 23 to 91 years (mean = 73 years). Most patients (73.0%) were male. Most tumors were 2 to 4 cm in size (51.4%). Regional metastases were common (50.8% cN+ and 65.1% pN+) and distant metastasis (7.3%) was uncommon. Occult nodes were found in 14.4% of cases. Overall survival at 5 and 10 years was 37% and 20%, respectively. Although numerous variables were found to significantly impact survival on univariate regression analysis, age (hazard ratio [HR]: 1.05, 95% confidence interval [CI]: 1.03‐1.08, P &lt; .001), tumor size of 2 to 4 cm (HR: 2.51, 95% CI: 1.83‐5.11, P = .011), tumors &gt;4 cm (HR: 3.44, 95% CI: 1.63‐7.27) and distant metastasis (HR: 2.06, 95% CI: 1.02‐4.14, P = .043) remained significant prognosticators in our multivariate model. Nodal disease was not a significant risk factor after adjustment (P = .055). Conclusions SmCC is a rare parotid malignancy with a poor prognosis. Regional metastases were common, whereas distant metastases were uncommon. Elective neck treatment should be considered due to the incidence of occult nodal disease. 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Study Design Retrospective database review. Methods We reviewed the NCDB (1998–2012) for all cases of parotid SmCC. Relevant demographic, tumor, and survival variables were extracted and analyzed. Cox multivariate regression was performed to identify prognosticators. Results Out of 30,813 parotid gland cancers in the NCDB, we found 344 cases of parotid SmCC (1.11%). Age at diagnosis ranged from 23 to 91 years (mean = 73 years). Most patients (73.0%) were male. Most tumors were 2 to 4 cm in size (51.4%). Regional metastases were common (50.8% cN+ and 65.1% pN+) and distant metastasis (7.3%) was uncommon. Occult nodes were found in 14.4% of cases. Overall survival at 5 and 10 years was 37% and 20%, respectively. Although numerous variables were found to significantly impact survival on univariate regression analysis, age (hazard ratio [HR]: 1.05, 95% confidence interval [CI]: 1.03‐1.08, P &lt; .001), tumor size of 2 to 4 cm (HR: 2.51, 95% CI: 1.83‐5.11, P = .011), tumors &gt;4 cm (HR: 3.44, 95% CI: 1.63‐7.27) and distant metastasis (HR: 2.06, 95% CI: 1.02‐4.14, P = .043) remained significant prognosticators in our multivariate model. Nodal disease was not a significant risk factor after adjustment (P = .055). Conclusions SmCC is a rare parotid malignancy with a poor prognosis. Regional metastases were common, whereas distant metastases were uncommon. Elective neck treatment should be considered due to the incidence of occult nodal disease. 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Study Design Retrospective database review. Methods We reviewed the NCDB (1998–2012) for all cases of parotid SmCC. Relevant demographic, tumor, and survival variables were extracted and analyzed. Cox multivariate regression was performed to identify prognosticators. Results Out of 30,813 parotid gland cancers in the NCDB, we found 344 cases of parotid SmCC (1.11%). Age at diagnosis ranged from 23 to 91 years (mean = 73 years). Most patients (73.0%) were male. Most tumors were 2 to 4 cm in size (51.4%). Regional metastases were common (50.8% cN+ and 65.1% pN+) and distant metastasis (7.3%) was uncommon. Occult nodes were found in 14.4% of cases. Overall survival at 5 and 10 years was 37% and 20%, respectively. Although numerous variables were found to significantly impact survival on univariate regression analysis, age (hazard ratio [HR]: 1.05, 95% confidence interval [CI]: 1.03‐1.08, P &lt; .001), tumor size of 2 to 4 cm (HR: 2.51, 95% CI: 1.83‐5.11, P = .011), tumors &gt;4 cm (HR: 3.44, 95% CI: 1.63‐7.27) and distant metastasis (HR: 2.06, 95% CI: 1.02‐4.14, P = .043) remained significant prognosticators in our multivariate model. Nodal disease was not a significant risk factor after adjustment (P = .055). Conclusions SmCC is a rare parotid malignancy with a poor prognosis. Regional metastases were common, whereas distant metastases were uncommon. Elective neck treatment should be considered due to the incidence of occult nodal disease. Level of Evidence 4 Laryngoscope, 126:2036–2040, 2016</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>26972357</pmid><doi>10.1002/lary.25923</doi><tpages>5</tpages></addata></record>
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subjects Adult
Aged
Aged, 80 and over
Carcinoma, Small Cell - mortality
Confidence intervals
Female
head and neck cancer
Humans
Male
Medical prognosis
Metastasis
Middle Aged
parotid cancer
Parotid Neoplasms - mortality
Prognosis
Retrospective Studies
salivary gland cancer
Small cell carcinoma
Survival Rate
Time Factors
Tumors
Young Adult
title Predictors of survival in parotid small cell carcinoma: A study of 344 cases
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