Small cell carcinoma of the head and neck: An analysis of the National Cancer Database

Pointer, Kelli B.; Ko, H.C.; Brower, Jeffrey V.; Witek, Matthew E.; Kimple, Randall J.; Lloyd, Ricardo V.; Harari, Paul M.; Baschnagel, Andrew M.

doi:10.1016/j.oraloncology.2017.04.009

Cited by 62 publications

(117 citation statements)

References 28 publications

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“…SmCCHN occurs in nearly all structures of the head and neck and most frequently originates in the larynx . Accepted therapeutic modalities include surgical resection, radiation therapy, or chemotherapy, although a recent study showed that there is no therapeutic advantage to treating with surgery in addition to chemotherapy and radiation in locally advanced disease . The infrequent occurrence of this tumor in the head and neck makes it difficult for investigators to gain clinical experience treating these tumors or report more than limited personal experience or case studies.…”

Section: Introductionmentioning

confidence: 99%

Small Cell and Squamous Cell Carcinomas of the Head and Neck: Comparing Incidence and Survival Trends Based on Surveillance, Epidemiology, and End Results (SEER) Data

et al. 2019

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Background. Small cell carcinomas of the head and neck (SmCCHNs) are rare neoplasms with an unfavorable prognosis. Population-based data describing survival and prognostic factors for SmCCHN are limited. Methods. Data were obtained from the U.S. National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database for 1973-2013. Patient and tumor-related characteristics for SmCCHN were compared with those for squamous cell carcinoma of the head and neck (SCCHN). Survival was compared by constructing Kaplan-Meier curves and Cox proportional hazard models with and without propensity score matching. Results. The data set included 609 SmCCHN and 227,943 SCCHN cases. Both histological subtypes were more common in men than women and more common in white patients. SmCCHN was most likely to originate in the larynx, glottis and hypopharynx, or salivary glands and to present with more advanced stage and grade. SCCHN was most likely to originate in the oral cavity and was found infrequently in the salivary glands. Overall 5-and 10-year survival estimates were 27% and 18% for SmCCHN and 46% and 31% for SCCHN, respectively. In multivariable survival analyses adjusting for age, sex, race, marital status, year of diagnosis, stage, grade, and receipt of radiation, the hazard ratio (HR) comparing SmCCHN with SCCHN was 1.53 with a 95% confidence interval (CI) from 1.39 to 1.68. Average 5-year survival varied widely between the histologic types when comparing tumor sites: 14.5% for SmCCHN versus 48.9% for SCCHN in the oropharynx. In propensity score matched analyses, the corresponding HR was 1.27 (95% CI, 1.15-1.40). Conclusion. Compared with SCCHN, SmCCHN carries a worse survival and is more likely to present with more advanced stage. The Oncologist 2019;24:1562-1569 Implications for Practice: Small cell carcinoma of the head and neck (SmCCHN) is a rare subtype of head and neck cancer. In this Surveillance, Epidemiology, and End Results (SEER) data analysis, the characteristics and survival of SmCCHN are compared with those of the common squamous cell carcinoma of the head and neck. Results show that SmCCHN carries a worse prognosis and tends to present at a more advanced stage; SmCCHN also is ten times more likely to originate from the salivary glands. These findings may have implications for clinical practice, as location of the tumor may strongly associate with the pathologic diagnosis. If a SmCCHN is diagnosed, a disseminated disease is likely; hence vigilance in staging procedures is indicated.

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Section: Introductionmentioning

confidence: 99%

Small Cell and Squamous Cell Carcinomas of the Head and Neck: Comparing Incidence and Survival Trends Based on Surveillance, Epidemiology, and End Results (SEER) Data

et al. 2019

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“…According to epidemiological reports, SmCCs arise most frequently in the lung and extrapulmonary small cell carcinomas are rare, only accounting for 2-4% of all SmCCs. 1 SmCC of the salivary gland is an extremely rare and aggressive malignancy representing less than 1% of all salivary gland tumors. 2 SmCC of the salivary gland could occur in both the major and minor salivary glands, with most cases affecting the parotid glands.…”

Section: Introductionmentioning

confidence: 99%

<p>Clinicopathological Characteristics and Survival of Small Cell Carcinoma of the Salivary Gland: a Population-Based Study</p>

Bai

Zhao

Pan

2019

CMAR

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Background: Small cell carcinoma (SmCC) of the salivary gland is rare, and the characteristics and survival are not well defined due to only case reports or case series being reported. The present study aimed to describe the clinicopathological characteristics and determine the factors associated with survival of this rare cancer. Materials and methods: A population-based study was carried out to investigate clinical characteristics and prognosis of SmCC of the salivary gland using prospectively extracted data from the Surveillance, Epidemiology and End Results (SEER) database between 1988 and 2016. Results: Totally, 198 patients with SmCC of the salivary gland were identified with an average age of 72.6±12.4 and a male to female ratio of 3.4:1. The lesions of most patients (167/198) were located in the parotid gland. The median overall survival (mOS) of all patients is 25.0 months. The 1-, 3-, 5-and 10-year survival rate was 65.7%, 40.9%, 33.0% and 22.7%, respectively. Surgery could prolong significantly the mOS by almost 17.0 months (28.0 months vs 11.0 months; P<0.01). Radiotherapy, as well as radiotherapy after surgery, could prolong the mOS (P<0.01 for both). Patients who received chemotherapy had significantly longer overall survival time than those without chemotherapy (28.0 months vs 20 months; P=0.04). The survival analysis demonstrated that old age (>72 years), lymph node (N3) and distant metastases were independent factors for poor survival, whereas radiotherapy was an independent factor for favorable survival. Conclusion: Small cell carcinoma of the salivary gland is a rare disease, and old age, lymph node and distant metastases, and radiotherapy were significantly associated with prognosis. In order to understand this disease more thoroughly, more cases with adequate information are required.

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“…SNEC accounts for only 11%–16% of all extrapulmonary small cell carcinomas, 2 and oropharyngeal tumors account for only 12.3% of all cancers in the head and neck. 6 SNEC often presents in older patients (age: 50–66 years) without sex bias; however, the majority of cases in the tonsil involve male patients, with a male to female ratio of 1.75:1. 10 Therefore, our current case is not consistent with the existing pattern.…”

Section: Discussionmentioning

confidence: 99%

“… 3 – 5 Many of the reported cases involved high-grade carcinomas, a highly invasive form of cancer with distant metastasis. 6 Some smaller series have reported that 14.5%–25% of patients present with distant metastatic disease. 7 , 8 Patients with a locally advanced stage and metastatic disease often have a low median survival rate, according to previous reports.…”

Section: Introductionmentioning

confidence: 99%

Successful cisplatin-etoposide chemotherapy-based treatment of a primary small cell neuroendocrine carcinoma of the tonsil with multiple metastases: a case report

Wang

Chen

Meng

2018

OTT

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Extrapulmonary small cell neuroendocrine carcinoma (SNEC) is an extremely rare and highly malignant tumor with a poor prognosis. Multiple metastases of SNEC are even more rare, and patients with locally advanced and metastatic disease generally face a poor outcome. To date, only a few cases of SNEC have been reported. Here, we describe a rare case of a 70-year-old female patient with SNEC of the tonsil who presented with multiple metastases and had achieved a complete response (CR) of the primary lesion and cervical lymph nodes for more than 1 year after receiving palliative chemotherapy. Initially, the patient presented with a 2-month history of throat pain. Magnetic resonance imaging and computed tomography revealed a soft mass with moderate enhancement on the left tonsil, which was confirmed by incisional aspiration biopsy. She was additionally sent for a positron emission tomography scan to evaluate small metastases in the left cervical lymph node, right lung, multiple mediastinal lymph nodes, and the fourth lumbar (L4) vertebra body metastases. Histopathological examination of the SNEC confirmed a nested, typical endocrine appearance with small round cells containing ovoid-shaped nuclei and high mitotic activity. Immunohistochemically, the tumor cells were positive for cytokeratin 8/18+, synaptophysin+, CD56+, and Ki-67 (<50%). The patient received 6 cycles of cisplatin combined with etoposide and was subsequently placed under close observation (<12 months). To date, she has achieved a CR of the primary lesion and cervical lymph nodes. In summary, we have described a case of successful treatment after chemotherapy for SNEC and have elucidated professional knowledge regarding the relevant aspects of SNEC.

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Small cell carcinoma of the head and neck: An analysis of the National Cancer Database

Cited by 62 publications

References 28 publications

Small Cell and Squamous Cell Carcinomas of the Head and Neck: Comparing Incidence and Survival Trends Based on Surveillance, Epidemiology, and End Results (SEER) Data

Small Cell and Squamous Cell Carcinomas of the Head and Neck: Comparing Incidence and Survival Trends Based on Surveillance, Epidemiology, and End Results (SEER) Data

<p>Clinicopathological Characteristics and Survival of Small Cell Carcinoma of the Salivary Gland: a Population-Based Study</p>

Successful cisplatin-etoposide chemotherapy-based treatment of a primary small cell neuroendocrine carcinoma of the tonsil with multiple metastases: a case report

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