Five-year outcomes of an oropharynx-directed treatment approach for unknown primary of the head and neck

Kenneth Shung Hu, Waleed Fouad Mourad, Mauricio E. Gamez, Wilson Lin, Adam Saul Jacobson, Mark Stephen Persky, Mark L. Urken, Bruce E. Culliney, Zujun Li, Theresa Nguyen Tran, Stimson Pryor Schantz, Juskaran Chadha, Louis Benjamin Harrison

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose Squamous cell carcinoma of unknown primary (SCCHNUP) is commonly treated with comprehensive radiation to the laryngopharynx and bilateral necks. In 1998, we established a departmental policy to treat SCCHNUP with radiation directed to the oropharynx and bilateral neck. Methods From 1998–2011, 60 patients were treated – N1: 18%, N2: 75% and N3: 7%. 82% underwent neck dissection. 55% received IMRT and 62% underwent concurrent chemoradiotherapy. Results At median follow-up of 54 months, 5 patients failed regionally and 4 emerged with a primary (tongue base, hypopharynx and thoracic esophagus). Five-year rates of regional control, primary emergence, distant metastasis, disease-free survival and overall survival were 90%, 10%, 20%, 72% and 79%, respectively. The 5 year rate of primary emergence in a non-oropharynx site was 3%. Conclusion This is the first demonstration that an oropharynx-directed approach yields low rates of primary emergence in SCCHNUP with excellent oncologic outcomes.

Original languageEnglish (US)
Pages (from-to)14-22
Number of pages9
JournalOral Oncology
Volume70
DOIs
StatePublished - Jul 1 2017

Fingerprint

Hypopharynx
Oropharynx
Neck
Head
Radiation
Neck Dissection
Chemoradiotherapy
Tongue
Esophagus
Disease-Free Survival
Squamous Cell Carcinoma
Thorax
Neoplasm Metastasis
Survival
Therapeutics

Keywords

  • Emergence
  • Oropharynx
  • Radiation
  • Unknown primary

ASJC Scopus subject areas

  • Oral Surgery
  • Oncology
  • Cancer Research

Cite this

Hu, K. S., Mourad, W. F., Gamez, M. E., Lin, W., Jacobson, A. S., Persky, M. S., ... Harrison, L. B. (2017). Five-year outcomes of an oropharynx-directed treatment approach for unknown primary of the head and neck. Oral Oncology, 70, 14-22. https://doi.org/10.1016/j.oraloncology.2017.05.001

Five-year outcomes of an oropharynx-directed treatment approach for unknown primary of the head and neck. / Hu, Kenneth Shung; Mourad, Waleed Fouad; Gamez, Mauricio E.; Lin, Wilson; Jacobson, Adam Saul; Persky, Mark Stephen; Urken, Mark L.; Culliney, Bruce E.; Li, Zujun; Tran, Theresa Nguyen; Schantz, Stimson Pryor; Chadha, Juskaran; Harrison, Louis Benjamin.

In: Oral Oncology, Vol. 70, 01.07.2017, p. 14-22.

Research output: Contribution to journalArticle

Hu, KS, Mourad, WF, Gamez, ME, Lin, W, Jacobson, AS, Persky, MS, Urken, ML, Culliney, BE, Li, Z, Tran, TN, Schantz, SP, Chadha, J & Harrison, LB 2017, 'Five-year outcomes of an oropharynx-directed treatment approach for unknown primary of the head and neck', Oral Oncology, vol. 70, pp. 14-22. https://doi.org/10.1016/j.oraloncology.2017.05.001
Hu, Kenneth Shung ; Mourad, Waleed Fouad ; Gamez, Mauricio E. ; Lin, Wilson ; Jacobson, Adam Saul ; Persky, Mark Stephen ; Urken, Mark L. ; Culliney, Bruce E. ; Li, Zujun ; Tran, Theresa Nguyen ; Schantz, Stimson Pryor ; Chadha, Juskaran ; Harrison, Louis Benjamin. / Five-year outcomes of an oropharynx-directed treatment approach for unknown primary of the head and neck. In: Oral Oncology. 2017 ; Vol. 70. pp. 14-22.
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abstract = "Purpose Squamous cell carcinoma of unknown primary (SCCHNUP) is commonly treated with comprehensive radiation to the laryngopharynx and bilateral necks. In 1998, we established a departmental policy to treat SCCHNUP with radiation directed to the oropharynx and bilateral neck. Methods From 1998–2011, 60 patients were treated – N1: 18{\%}, N2: 75{\%} and N3: 7{\%}. 82{\%} underwent neck dissection. 55{\%} received IMRT and 62{\%} underwent concurrent chemoradiotherapy. Results At median follow-up of 54 months, 5 patients failed regionally and 4 emerged with a primary (tongue base, hypopharynx and thoracic esophagus). Five-year rates of regional control, primary emergence, distant metastasis, disease-free survival and overall survival were 90{\%}, 10{\%}, 20{\%}, 72{\%} and 79{\%}, respectively. The 5 year rate of primary emergence in a non-oropharynx site was 3{\%}. Conclusion This is the first demonstration that an oropharynx-directed approach yields low rates of primary emergence in SCCHNUP with excellent oncologic outcomes.",
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AU - Harrison, Louis Benjamin

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AB - Purpose Squamous cell carcinoma of unknown primary (SCCHNUP) is commonly treated with comprehensive radiation to the laryngopharynx and bilateral necks. In 1998, we established a departmental policy to treat SCCHNUP with radiation directed to the oropharynx and bilateral neck. Methods From 1998–2011, 60 patients were treated – N1: 18%, N2: 75% and N3: 7%. 82% underwent neck dissection. 55% received IMRT and 62% underwent concurrent chemoradiotherapy. Results At median follow-up of 54 months, 5 patients failed regionally and 4 emerged with a primary (tongue base, hypopharynx and thoracic esophagus). Five-year rates of regional control, primary emergence, distant metastasis, disease-free survival and overall survival were 90%, 10%, 20%, 72% and 79%, respectively. The 5 year rate of primary emergence in a non-oropharynx site was 3%. Conclusion This is the first demonstration that an oropharynx-directed approach yields low rates of primary emergence in SCCHNUP with excellent oncologic outcomes.

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