{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T16:40:50Z","timestamp":1765039250129,"version":"build-2065373602"},"reference-count":36,"publisher":"Wiley","issue":"22","license":[{"start":{"date-parts":[[2014,7,24]],"date-time":"2014-07-24T00:00:00Z","timestamp":1406160000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2014,11,15]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The current study was conducted to develop a multifactorial statistical model to predict the specific head and neck (H&amp;N) tumor site origin in cases of squamous cell carcinoma confined to the cervical lymph nodes (\u201cunknown primaries\u201d).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The Surveillance, Epidemiology, and End Results (SEER) database was analyzed for patients with an H&amp;N tumor site who were diagnosed between 2004 and 2011. The SEER patients were identified according to their H&amp;N primary tumor site and clinically positive cervical lymph node levels at the time of presentation. The SEER patient data set was randomly divided into 2 data sets for the purposes of internal split\u2010sample validation. The effects of cervical lymph node levels, age, race, and sex on H&amp;N primary tumor site were examined using univariate and multivariate analyses. Multivariate logistic regression models and an associated set of nomograms were developed based on relevant factors to provide probabilities of tumor site origin.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Analysis of the SEER database identified 20,011 patients with H&amp;N disease with both site\u2010level and lymph node\u2010level data. Sex, race, age, and lymph node levels were associated with primary H&amp;N tumor site (nasopharynx, hypopharynx, oropharynx, and larynx) in the multivariate models. Internal validation techniques affirmed the accuracy of these models on separate data.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The incorporation of epidemiologic and lymph node data into a predictive model has the potential to provide valuable guidance to clinicians in the treatment of patients with squamous cell carcinoma confined to the cervical lymph nodes. <jats:bold><jats:italic>Cancer<\/jats:italic> 2014;120:3469\u20133476<\/jats:bold>. \u00a9 2014 The Authors. <jats:italic>Cancer<\/jats:italic> published by Wiley Periodicals, Inc. on behalf of <jats:italic>American Cancer Society<\/jats:italic>. This is an open access article under the terms of the Creative Commons Attribution\u2010NonCommercial\u2010NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non\u2010commercial and no modifications or adaptations are made.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.28901","type":"journal-article","created":{"date-parts":[[2014,7,24]],"date-time":"2014-07-24T14:29:00Z","timestamp":1406212140000},"page":"3469-3476","source":"Crossref","is-referenced-by-count":9,"title":["A model and nomogram to predict tumor site origin for squamous cell cancer confined to cervical lymph nodes"],"prefix":"10.1002","volume":"120","author":[{"given":"Arif N.","family":"Ali","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Winship Cancer Institute, Emory University Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey 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