AUTHOR=Matsuyama Hiroshi , Ueki Yushi , Okamoto Isaku , Nagao Toshitaka , Honda Kohei , Yamazaki Keisuke , Okabe Ryuichi , Togashi Takafumi , Shodo Ryusuke , Ota Hisayuki , Takahashi Takeshi , Omata Jo , Yokoyama Yusuke , Saijo Kohei , Tanaka Ryoko , Tsukahara Kiyoaki , Kitahara Tadashi , Uemura Hirokazu , Yoshimoto Seiichi , Matsumoto Fumihiko , Okami Kenji , Sakai Akihiro , Takano Kenichi , Kondo Atsushi , Inohara Hidenori , Eguchi Hirotaka , Oridate Nobuhiko , Tanabe Teruhiko , Nakamizo Munenaga , Yokoshima Kazuhiko , Miura Koki , Kitani Yosuke , Horii Arata 

TITLE=Head and neck small-cell carcinoma: A multicenter study of 39 cases from 10 institutions

JOURNAL=Frontiers in Surgery

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.1049116

DOI=10.3389/fsurg.2022.1049116

ISSN=2296-875X

ABSTRACT=<sec><title>Objective</title><p>Basal information of head and neck small-cell carcinoma (HNSmCC) including epidemiology, primary site, treatment, and prognosis remains sparse due to its rarity. We report here a multicenter retrospective study on the diagnosis, treatment, and outcomes of patients with HNSmCC.</p></sec><sec><title>Materials and methods</title><p>This study involved 47 patients with HNSmCC from 10 participating institutions. Eight patients were excluded for whom no pathological specimens were available (<italic>n</italic> = 2) and for discrepant central pathological judgements (<italic>n</italic> = 6). The remaining 39 patients were processed for data analysis.</p></sec><sec><title>Results</title><p>As pretreatment examinations, computed tomography (CT) was performed for the brain (<italic>n</italic> = 8), neck (<italic>n</italic> = 39), and chest (<italic>n</italic> = 32), magnetic resonance imaging (MRI) for the brain (<italic>n</italic> = 4) and neck (<italic>n</italic> = 23), positron emission tomography-CT (PET-CT) in 23 patients, bone scintigraphy in 4, neck ultrasonography in 9, and tumor markers in 25. Primary sites were oral cavity (<italic>n</italic> = 1), nasal cavity/paranasal sinuses (<italic>n</italic> = 16), nasopharynx (<italic>n</italic> = 2), oropharynx (<italic>n</italic> = 4), hypopharynx (<italic>n</italic> = 2), larynx (<italic>n</italic> = 6), salivary gland (<italic>n</italic> = 3), thyroid (<italic>n</italic> = 2), and others (<italic>n</italic> = 3). Stages were II/III/IV-A/IV-B/IV-C/Not determined = 3/5/16/6/5/4; stage IV comprised 69%. No patient had brain metastases. First-line treatments were divided into 3 groups: the chemoradiotherapy (CRT) group (<italic>n</italic> = 27), non-CRT group (<italic>n</italic> = 8), and best supportive care group (<italic>n</italic> = 4). The CRT group included concurrent CRT (CCRT) (<italic>n</italic> = 17), chemotherapy (Chemo) followed by radiotherapy (RT) (<italic>n</italic> = 5), and surgery (Surg) followed by CCRT (<italic>n</italic> = 5). The non-CRT group included Surg followed by RT (<italic>n</italic> = 2), Surg followed by Chemo (<italic>n</italic> = 1), RT alone (<italic>n</italic> = 2), and Chemo alone (<italic>n</italic> = 3). The 1-year/2-year overall survival (OS) of all 39 patients was 65.3/53.3%. The 1-year OS of the CRT group (77.6%) was significantly better compared with the non-CRT group (31.3%). There were no significant differences in adverse events between the CCRT group (<italic>n</italic> = 22) and the Chemo without concurrent RT group (<italic>n</italic> = 9).</p></sec><sec><title>Conclusion</title><p>Neck and chest CT, neck MRI, and PET-CT would be necessary and sufficient examinations in the diagnostic set up for HNSmCC. CCRT may be recommended as the first-line treatment. The 1-year/2-year OS was 65.3%/53.3%. This study would provide basal data for a proposing the diagnostic and treatment algorithms for HNSmCC.</p></sec>