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

Purpose/objective(s): To evaluate treatment trends and overall survival of patients with small cell carcinoma of the head and neck region. Materials/methods: Patients from 2004 to 2012 were identified from the National Cancer Database. Patient demographics and overall survival were analyzed. Multivariable analysis was used to identify predictors of survival. Results: Among 347,252 head and neck patients a total of 1042 (0.3%) patients with small cell carcinoma were identified. 17% of patients were diagnosed as stage I/II, 61% as stage III/IVA/IVB and 22% as stage IVC disease. The distribution by anatomic site was 9% oral cavity, 12% oropharynx, 35% larynx, 4% hypopharynx, 10% nasopharynx and 30% nasal cavity and paranasal sinuses. The median overall survival by anatomical site was 20.8 months for oral cavity, 23.7 months for oropharynx, 17.9 months for larynx/hypopharynx, 15.1 months for nasopharynx and 36.4 months for nasal cavity primary tumors. On multivariable analysis across stage, patients with nasal cavity and paranasal sinuses tumors had the best survival and patients with nasopharynx primaries had the worst survival. In stage I/II patients, type of treatment delivered resulted in no overall survival difference (p = 0.78). In patients with locally advanced disease, there was no difference in survival between those treated with combined surgery, radiotherapy and chemotherapy compared to those treated only with radiotherapy and chemotherapy (p = 0.46). The addition of radiotherapy to chemotherapy in the metastatic setting did not result in improved survival (p = 0.14). Conclusions: Small cell carcinoma of the head and neck is a rare malignancy with a poor prognosis. The addition of surgery to radiotherapy and chemotherapy did not improve survival in patients with locally advanced disease. (C) 2017 Elsevier Ltd. All rights reserved.