Carcinoma of unknown primary and the 8th Edition TNM Classification for Head and Neck Cancer

Introduction In the 8th Edition TNM Classification for Head and Neck Cancer, the classification for Carcinoma of unknown primary changed in addition to the oropharyngeal carcinomas. The aim of the study was to investigate the influence of the new classification on the prognosis of p16-positive and negative Carcinoma of unknown primary.

Methods Evaluation of clinical and pathological data from patients with Carcinoma of unknown primary treated at the Charité between 2009 and 2018.

Results There were 110 patients treated, 28 % women and 72 % men. The average age at first diagnosis was 66 years. 79 % were smokers, 50 % were positive for p16 and 63 % had capsule-exceeding growth. The UICC tumor stage (according to 7th classification) for III, IVA, IVB and IVC was present in 20 %, 73 %, 15 % and 2 %. The median overall survival was 51 months (95 % CI 30-72 months). In univariate analysis, the tumor stage (p <0.0001) had a significant effect on survival, while p16 and smoking had no significant effect. The 8th TNM classification resulted in an downstaging of p16-positive CUP syndromes and a upstaging of p16 negative syndromes.

Summary The prognosis of Carcinoma of unknown primary depends on the tumor stage. The 8th TNM classification shows the lower tumor stage in p16-positive CUP syndromes.

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Publication History

Article published online:
10 June 2020