Impact of American Joint Committee on Cancer Eighth Edition clinical stage and smoking history on oncologic outcomes in human papillomavirus-associated oropharyngeal squamous cell carcinoma.
Adult
Advisory Committees
/ standards
Aged
Aged, 80 and over
Carcinoma, Squamous Cell
/ mortality
Cohort Studies
Disease-Free Survival
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Invasiveness
/ pathology
Neoplasm Recurrence, Local
/ pathology
Neoplasm Staging
Oropharyngeal Neoplasms
/ mortality
Papillomavirus Infections
/ complications
Prognosis
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Smoking
/ adverse effects
Survival Analysis
United States
American Joint Committee on Cancer
clinical staging
human papillomavirus (HPV)
oropharyngeal squamous cell carcinoma
smoking
Journal
Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
received:
15
11
2017
revised:
22
01
2018
accepted:
07
05
2018
pubmed:
19
2
2019
medline:
10
10
2020
entrez:
19
2
2019
Statut:
ppublish
Résumé
The purpose of this study was to evaluate the AJCC eighth edition clinical staging system for human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma and to further understand how clinical stage and smoking history affect oncologic outcomes. The purpose of this study was to present the understanding of how clinical stage and smoking history affect oncologic outcomes in human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (SCC) is critical for selecting patients for treatment deintensification. Kaplan-Meier and Cox regression were used to evaluate overall survival (OS), locoregional recurrence-free survival (LRFS), and distant recurrence-free survival (DRFS). Concordance statistics (C-indices) were used to compare discriminating ability. The OS and DRFS but not LRFS were significantly distributed using the American Joint Committee on Cancer (AJCC) seventh and eighth editions criteria. The C-indices for OS, LRFS, and DRFS were 0.57, 0.54, and 0.60, respectively, using the AJCC seventh edition, and 0.63, 0.53, and 0.65, respectively, using the AJCC eighth edition. On multivariate analysis, 1 + pack-year smoking history correlated with OS (hazard ratio [HR] 1.96; 95% confidence interval [CI] 1.2-3.1; P < .01) but not LRFS or DRFS. These results support implementation of the AJCC eighth edition for HPV-associated oropharyngeal SCC. Clinical stage may be more important than smoking history in selection for deintensification.
Sections du résumé
BACKGROUND
The purpose of this study was to evaluate the AJCC eighth edition clinical staging system for human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma and to further understand how clinical stage and smoking history affect oncologic outcomes. The purpose of this study was to present the understanding of how clinical stage and smoking history affect oncologic outcomes in human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (SCC) is critical for selecting patients for treatment deintensification.
METHODS
Kaplan-Meier and Cox regression were used to evaluate overall survival (OS), locoregional recurrence-free survival (LRFS), and distant recurrence-free survival (DRFS). Concordance statistics (C-indices) were used to compare discriminating ability.
RESULTS
The OS and DRFS but not LRFS were significantly distributed using the American Joint Committee on Cancer (AJCC) seventh and eighth editions criteria. The C-indices for OS, LRFS, and DRFS were 0.57, 0.54, and 0.60, respectively, using the AJCC seventh edition, and 0.63, 0.53, and 0.65, respectively, using the AJCC eighth edition. On multivariate analysis, 1 + pack-year smoking history correlated with OS (hazard ratio [HR] 1.96; 95% confidence interval [CI] 1.2-3.1; P < .01) but not LRFS or DRFS.
CONCLUSION
These results support implementation of the AJCC eighth edition for HPV-associated oropharyngeal SCC. Clinical stage may be more important than smoking history in selection for deintensification.
Identifiants
pubmed: 30775826
doi: 10.1002/hed.25336
pmc: PMC6420360
mid: NIHMS966816
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
857-864Subventions
Organisme : NCI NIH HHS
ID : P50 CA097248
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA184153
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA194536
Pays : United States
Organisme : Newman Family Professorship Fund
ID : RO1 CA184153
Pays : International
Informations de copyright
© 2018 Wiley Periodicals, Inc.
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