Date of Award

9-24-2020

Department

Department of Endodontics

First Advisor

Dr. Darren P. Cox

First Committee Member

Dr. Darren P. Cox

Second Committee Member

Dr. Johnah C. Galicia

Third Committee Member

Dr. Eric S. Salmon

Abstract

Introduction: Lymphoepithelial carcinoma (LEC) in the oropharynx is rare. Current understanding of the disease is derived mainly from case reports and small case series, prompting further elucidation of its epidemiology and prognostic factors that affect outcome. The aim of this retrospective cohort study was to examine demographic characteristics, clinicopathologic features, and prognostic factors in patients with oropharyngeal LEC. Methods: The U.S. National Cancer Institute’s SEER registry was queried to obtain data on patients with primary oropharyngeal LEC from 1975 to 2016. Variables examined include age at diagnosis, sex, race, year of diagnosis, primary site of tumor origin, tumor size, extent, nodal status, overall stage, tumor grade, surgical treatment, and county socioeconomic status (SES). Kaplan-Meier univariable and Cox regression model multivariable analyses were conducted to identify independent predictors of survival. Results: In total, 199 cases of primary LEC in the oropharynx were found. Overall survival rates at 2-, 5-, and 10-years were 81.0%, 74.0%, and 56.0%, respectively. Disease-specific survival rates at 2-, 5-, and 10-years were 85.0%, 80.0%, and 77.0%, respectively. Multivariable analysis identified older age at diagnosis, Black race, and tonsil primary site to be independent predictors of worse survival. Contrarily, a more recent year of diagnosis, surgical resection, and higher county SES were identified to be associated with an improved prognosis. Conclusion: Oropharyngeal LEC is a rare malignancy that is diagnosed mostly in White males in the fifth decade of life. Patient age, race, year of diagnosis, primary site of tumor origin, surgical treatment, and county SES were found to significantly affect survival. Although oropharyngeal LEC is associated with a relatively favorable prognosis, detecting disease early and including surgical resection in treatment may aid in further improving survival.

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