Comparative effectiveness of surgery versus radiotherapy for non-nasopharyngeal head and neck lymphoepithelial carcinoma: An IPTW propensity score analysis.
<h4>Background</h4>Lymphoepithelial carcinoma (LEC) is a rare head and neck malignancy predominately treated with radiotherapy or surgery. However, comparative effectiveness studies, are lacking for non-nasopharyngeal head and neck LEC (HNLEC).<h4>Methods</h4>Patients diagnos...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2025-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0321318 |
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| Summary: | <h4>Background</h4>Lymphoepithelial carcinoma (LEC) is a rare head and neck malignancy predominately treated with radiotherapy or surgery. However, comparative effectiveness studies, are lacking for non-nasopharyngeal head and neck LEC (HNLEC).<h4>Methods</h4>Patients diagnosed with non-nasopharyngeal HNLEC from 2000-2019 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Inverse probability of treatment weighting (IPTW) was used to balance baseline characteristics. Cancer-specific survival (CSS) was compared between surgery and radiotherapy groups using Kaplan-Meier analyses and Cox regression before and after IPTW adjustment.<h4>Results</h4>248 patients were included. Before IPTW adjustment, treatment modalities were not significantly associated with CSS in both Kaplan-Meier analysis(p=0.065) and univariate Cox regression(p=0.068). After weighting, Kaplan-Meier analysis revealed a significant CSS difference favoring surgery (p=0.015), and univariate Cox regression showed surgery (p=0.018), race (p<0.001), tumor size (p=0.024) and radiotherapy (p=0.0003) as independent predictors. On subgroup analysis of patients receiving single-modality therapy, landmark analysis beyond 60 months showed improved CSS with surgery versus radiotherapy (p<0.001) after IPTW adjustment. Additionally, Kaplan-Meier analysis showed no pre-IPTW (p=0.68) or post-IPTW (p=0.30) CSS differences between surgery alone and surgery plus radiotherapy.<h4>Conclusion</h4>This population-based analysis demonstrated a potential survival advantage of surgery over radiotherapy for non-nasopharyngeal head and neck LEC after accounting for confounding factors. Additional comparative effectiveness data, ideally from controlled studies, are warranted to further investigate optimal treatment strategies. |
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| ISSN: | 1932-6203 |