TY - JOUR
T1 - Predictors of survival in parotid small cell carcinoma
T2 - A study of 344 cases
AU - Zhan, Kevin Y.
AU - Din, Hassieb A.
AU - Muus, John S.
AU - Nguyen, Shaun A.
AU - Lentsch, Eric J.
N1 - Publisher Copyright:
© 2016 The American Laryngological, Rhinological and Otological Society, Inc.
PY - 2016/9/1
Y1 - 2016/9/1
N2 - 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.
AB - 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.
KW - head and neck cancer
KW - parotid cancer
KW - salivary gland cancer
KW - Small cell carcinoma
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U2 - 10.1002/lary.25923
DO - 10.1002/lary.25923
M3 - Article
C2 - 26972357
AN - SCOPUS:84983389869
SN - 0023-852X
VL - 126
SP - 2036
EP - 2040
JO - Laryngoscope
JF - Laryngoscope
IS - 9
ER -