National cancer data base report on malignant paragangliomas of the head and neck

John H. Lee, Frank Barich, Lucy Hynds Karnell, Robert A. Robinson, Weining Zhen, Bruce J. Gantz, Henry T. Hoffman

Research output: Contribution to journalArticle

224 Citations (Scopus)

Abstract

BACKGROUND. Malignant paragangliomas of the head and neck are rare, with previous reports limited to nine or fewer patients. The current review included 59 cases extracted from the National Cancer Data Base that were diagnosed between 1985-1996. METHODS. The primary criterion for inclusion in the current study was verified metastatic spread from a paraganglioma of the head and neck. Patterns of presentation and treatment as well as clinically relevant associations were demonstrated in contingency tables. Relative survival was used for analysis of outcome. RESULTS. The average patient age at presentation was 44 years, and gender distribution was equivalent. Metastases were confined to regional lymph nodes in the majority of cases (68.6%), with carotid body tumors found to have an even higher rate of regional confinement (93.8%). Surgery was the most common treatment (76.3%). The use of adjuvant irradiation for regionally confined disease increased across time, from 27% (1985-1990) to 46% (1991-1996). The 5-year relative survival rate was 59.5% (76.8% for regionally confined carcinoma and 11.8% for distant metastasis). Among patients who were followed until death, those treated with adjuvant irradiation had a longer median survival (45 months) compared with those patients who were treated with surgery alone (12 months). CONCLUSIONS. Malignant paraganglioma represents metastatic spread of a tumor type that, when restricted to the site of origin, is considered benign. Metastases from malignant paragangliomas of the head and neck usually are regionally confined. The primary management of a recognized malignancy should be directed toward complete surgical removal of the primary tumor and regional lymph nodes. Postoperative irradiation may be beneficial in slowing the progression of residual disease.

Original languageEnglish (US)
Pages (from-to)730-737
Number of pages8
JournalCancer
Volume94
Issue number3
DOIs
StatePublished - Feb 1 2002

Fingerprint

Paraganglioma
Neck
Head
Databases
Neoplasm Metastasis
Neoplasms
Lymph Nodes
Carotid Body Tumor
Survival
Disease Progression
Survival Rate
Carcinoma
Therapeutics

Keywords

  • Head and neck carcinoma
  • Malignant paraganglioma
  • National Cancer Data Base (NCDB)
  • National survey

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Lee, J. H., Barich, F., Karnell, L. H., Robinson, R. A., Zhen, W., Gantz, B. J., & Hoffman, H. T. (2002). National cancer data base report on malignant paragangliomas of the head and neck. Cancer, 94(3), 730-737. https://doi.org/10.1002/cncr.10252

National cancer data base report on malignant paragangliomas of the head and neck. / Lee, John H.; Barich, Frank; Karnell, Lucy Hynds; Robinson, Robert A.; Zhen, Weining; Gantz, Bruce J.; Hoffman, Henry T.

In: Cancer, Vol. 94, No. 3, 01.02.2002, p. 730-737.

Research output: Contribution to journalArticle

Lee, JH, Barich, F, Karnell, LH, Robinson, RA, Zhen, W, Gantz, BJ & Hoffman, HT 2002, 'National cancer data base report on malignant paragangliomas of the head and neck', Cancer, vol. 94, no. 3, pp. 730-737. https://doi.org/10.1002/cncr.10252
Lee JH, Barich F, Karnell LH, Robinson RA, Zhen W, Gantz BJ et al. National cancer data base report on malignant paragangliomas of the head and neck. Cancer. 2002 Feb 1;94(3):730-737. https://doi.org/10.1002/cncr.10252
Lee, John H. ; Barich, Frank ; Karnell, Lucy Hynds ; Robinson, Robert A. ; Zhen, Weining ; Gantz, Bruce J. ; Hoffman, Henry T. / National cancer data base report on malignant paragangliomas of the head and neck. In: Cancer. 2002 ; Vol. 94, No. 3. pp. 730-737.
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AU - Karnell, Lucy Hynds

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AU - Gantz, Bruce J.

AU - Hoffman, Henry T.

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N2 - BACKGROUND. Malignant paragangliomas of the head and neck are rare, with previous reports limited to nine or fewer patients. The current review included 59 cases extracted from the National Cancer Data Base that were diagnosed between 1985-1996. METHODS. The primary criterion for inclusion in the current study was verified metastatic spread from a paraganglioma of the head and neck. Patterns of presentation and treatment as well as clinically relevant associations were demonstrated in contingency tables. Relative survival was used for analysis of outcome. RESULTS. The average patient age at presentation was 44 years, and gender distribution was equivalent. Metastases were confined to regional lymph nodes in the majority of cases (68.6%), with carotid body tumors found to have an even higher rate of regional confinement (93.8%). Surgery was the most common treatment (76.3%). The use of adjuvant irradiation for regionally confined disease increased across time, from 27% (1985-1990) to 46% (1991-1996). The 5-year relative survival rate was 59.5% (76.8% for regionally confined carcinoma and 11.8% for distant metastasis). Among patients who were followed until death, those treated with adjuvant irradiation had a longer median survival (45 months) compared with those patients who were treated with surgery alone (12 months). CONCLUSIONS. Malignant paraganglioma represents metastatic spread of a tumor type that, when restricted to the site of origin, is considered benign. Metastases from malignant paragangliomas of the head and neck usually are regionally confined. The primary management of a recognized malignancy should be directed toward complete surgical removal of the primary tumor and regional lymph nodes. Postoperative irradiation may be beneficial in slowing the progression of residual disease.

AB - BACKGROUND. Malignant paragangliomas of the head and neck are rare, with previous reports limited to nine or fewer patients. The current review included 59 cases extracted from the National Cancer Data Base that were diagnosed between 1985-1996. METHODS. The primary criterion for inclusion in the current study was verified metastatic spread from a paraganglioma of the head and neck. Patterns of presentation and treatment as well as clinically relevant associations were demonstrated in contingency tables. Relative survival was used for analysis of outcome. RESULTS. The average patient age at presentation was 44 years, and gender distribution was equivalent. Metastases were confined to regional lymph nodes in the majority of cases (68.6%), with carotid body tumors found to have an even higher rate of regional confinement (93.8%). Surgery was the most common treatment (76.3%). The use of adjuvant irradiation for regionally confined disease increased across time, from 27% (1985-1990) to 46% (1991-1996). The 5-year relative survival rate was 59.5% (76.8% for regionally confined carcinoma and 11.8% for distant metastasis). Among patients who were followed until death, those treated with adjuvant irradiation had a longer median survival (45 months) compared with those patients who were treated with surgery alone (12 months). CONCLUSIONS. Malignant paraganglioma represents metastatic spread of a tumor type that, when restricted to the site of origin, is considered benign. Metastases from malignant paragangliomas of the head and neck usually are regionally confined. The primary management of a recognized malignancy should be directed toward complete surgical removal of the primary tumor and regional lymph nodes. Postoperative irradiation may be beneficial in slowing the progression of residual disease.

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