Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
PLoS One. 2024 Oct 24;19(10):e0312455. doi: 10.1371/journal.pone.0312455. eCollection 2024.
Head and neck small-cell carcinoma (HNSmCC) is a rare and aggressive cancer with a high tendency for distant metastasis. It is treated with multimodal treatment involving chemotherapy. Occasionally, surgery is performed for the management of locoregional HNSmCC. However, the benefits of surgery in this context have not yet been elucidated. Therefore, in this study, we aimed to investigate whether surgery could improve the survival of patients with HNSmCC.
We obtained data from patients with locoregional HNSmCC treated with chemoradiation therapy (CRT) from the Surveillance, Epidemiology, and End Results database. Patients who did and did not undergo surgery were matched using propensity scores. The overall survival (OS) and disease-specific survival (DSS) rates were estimated using the Kaplan-Meier method and tested using the log-rank test. Hazard ratios (HRs) were calculated using the Cox proportional hazard model.
The 5-year OS rates of the patients who did and did not undergo surgery were 57.2% and 50.6%, respectively (P = 0.689); the corresponding 5-year DSS rates were 61.0% and 57.5% (P = 0.769). The adjusted HRs for surgery were 0.85 (95% confidence interval [CI]: 0.54-1.33) for OS and 0.87 (95% CI: 0.51-1.49) for DSS.
The addition of surgery to CRT did not improve the survival of patients with locoregional HNSmCC.
头颈部小细胞癌（HNSmCC）是一种罕见且侵袭性强的癌症，远处转移倾向高。它采用包括化疗在内的多模式治疗。偶尔，手术用于局部晚期 HNSmCC 的治疗。然而，手术在这种情况下的益处尚未阐明。因此，在这项研究中，我们旨在研究手术是否可以改善 HNSmCC 患者的生存。
我们从监测、流行病学和最终结果数据库中获取了接受放化疗（CRT）治疗的局部晚期 HNSmCC 患者的数据。使用倾向评分对接受手术和未接受手术的患者进行匹配。使用 Kaplan-Meier 方法估计总生存期（OS）和疾病特异性生存期（DSS）率，并使用对数秩检验进行检验。使用 Cox 比例风险模型计算危险比（HRs）。
接受手术和未接受手术的患者的 5 年 OS 率分别为 57.2%和 50.6%（P=0.689）；相应的 5 年 DSS 率分别为 61.0%和 57.5%（P=0.769）。手术的调整 HR 分别为 OS 的 0.85（95%置信区间 [CI]：0.54-1.33）和 DSS 的 0.87（95% CI：0.51-1.49）。
在 CRT 中加入手术并未改善局部晚期 HNSmCC 患者的生存。
