Pediatric head and neck squamous cell carcinoma: Patient demographics, treatment trends and outcomes

Objectives: To examine patient demographics, temporal and treatment trends, and survival outcomes of pediatric non-nasopharyngeal head and neck squamous cell carcinomas using the National Cancer Database. Methods: The National Cancer Database was queried for pediatric patients (age 0-19 years) diagnosed with squamous cell carcinoma of the head and neck (including oral cavity, oropharynx, nasal cavity, larynx, hypo pharynx, and salivary glands) from 2004 to 2013. Results: Of 159 patients identified, the majority had oral cavity SCC (55%). There was no discernable change in incidence trends over the study period with the number of cases per year ranging from 10 to 20 (R-2 = 0.174). The predominant treatment regimen for the nasal cavity was trimodality (surgery, radiation, and chemotherapy) treatment (29%), chemotherapy and radiation for the oropharynx (40%), and surgery alone for salivary gland (47%), oral cavity (44%), and larynx (22%). The 5-year overall survival for the entire cohort was 74% and by subsite: oral cavity (66%), oropharynx (68%), nasal cavity (75%), and larynx (95%). Laryngeal disease had statistically significant longer survival when compared to oral cavity (p = .031) or oropharynx (p = .029). Conclusion: Although pediatric non-nasopharyngeal head and neck squamous cell carcinomas are rare, practitioners should be aware of this entity and consider it in the differential diagnosis of pediatric malignancies.