Clinicopathological characteristics, treatment and prognosis of head & neck small cell carcinoma: a SEER population-
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RESEARCH ARTICLE
Open Access
Clinicopathological characteristics, treatment and prognosis of head & neck small cell carcinoma: a SEER populationbased study Chen-xi Yu1,2†, Feiluore Yibulayin1,3†, Lei Feng1, Meng Wang1, Meng-meng Lu1, Yuan Luo1, Hui Liu1, Zhi-cheng Yang1* and Alimujiang Wushou1*
Abstract Background: To investigate the clinicopathological characteristics of head and neck small cell carcinoma (H&NSmCC) and identify prognostic factors on the basis of the Surveillance, Epidemiology and End Results (SEER) database. Methods: Total of 789 primary cases from 1973 to 2016 were included. Univariate and multivariate analyses were performed to identify independent prognostic indicators. An H&NSmCC-specific nomogram was constructed and compared with the AJCC staging system by calculating the time-dependent area under the curve (AUC) of the receiver operating characteristic (ROC) curves. Results: The incidence of H&NSmCC peaked during the period of 50 to 70 years old, and the most frequent location was the salivary gland. The 5-year disease specific survival (DSS) was 27%. In the multivariate survival analysis, AJCC III + IV stage [HR = 2.5, P = 0.03, I + II stage as Ref], positive N stage [HR = 1.67, P = 0.05, negative N stage as Ref], positive M stage [HR = 4.12, P = 0.000, negative M stage as Ref] and without chemotherapy [HR = 0.56, P = 0.023, received chemotherapy as Ref] were independently associated with DSS. The H&NSmCC-specific nomogram was built based on the independent prognostic indicators. The nomogram demonstrated better predictive capacity than the AJCC staging system for 5-year DSS [(AUC: 0.75 vs 0.634; Harrell’s C-index (95% CI): 0.7(0.66–0.74) vs 0.59(0.55–0.62), P < 0.05]. Conclusion: N stage, M stage, AJCC stage and chemotherapy were independent prognostic indicators included in the prognostic nomogram model, which can better predict the survival of H&NSmCC than the AJCC staging system. Keywords: Small cell carcinomas, Head & neck, SEER analysis, Survival, Prognostic model
* Correspondence: [email protected]; [email protected] † Chen-xi Yu and Feiluore Yibulayin contributed equally to this work. 1 Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, 356 Beijing East Road, Shanghai 200001, People’s Republic of China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons
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