Combined chemoradiotherapy showed improved outcome with early-stage HPV-positive oropharyngeal cancers.
Human papillomavirus
Oropharyngeal squamous cell carcinoma
Staging
Survival analysis
Treatment
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
07 May 2022
07 May 2022
Historique:
received:
31
12
2021
accepted:
24
03
2022
entrez:
7
5
2022
pubmed:
8
5
2022
medline:
11
5
2022
Statut:
epublish
Résumé
The revised 8th Edition American Joint Committee on Cancer (AJCC) Head and Neck Staging Manual distinguishes HPV-mediated from non-HPV-mediated oropharyngeal cancer (OpSCC). The objective was to analyze OpSCC treatment modalities and outcomes. A retrospective study of OpSCC patients treated with radiotherapy or chemoradiotherapy between January 1st, 2000, and December 31st, 2008, as identified from the BC Cancer Registry. All patients received treatment at cancer clinics and had at least 5 years follow-up post-treatment. A total of 1259 OpSCC patients were identified. After initial chart reviews, 288 patients were excluded from further analysis and the majority (n = 198) was due to not receiving curative treatment. Based on the availability of formalin-fixed, paraffin-embedded (FFPE) tissue, patients were divided into two cohorts: Study Cohort (FFPE available, n = 244) and General Cohort (FFPE unavailable, n = 727). The Study Cohort was restaged according to AJCC 8th Edition based on p16 immunohistochemistry status. Kaplan-Meier analysis was used to estimate the 5-year overall survival (OS), disease-specific survival (DSS), and locoregional recurrence-free survival (LFS). Among 971 patients, OpSCC age-adjusted incidence rate was observed to have increased from 2.1 to 3.5 per 100,000 between 2000 and 2008. The General Cohort was relatively older than the Study Cohort (60.1 ± 10.5 vs. 57.3 ± 9.4), but both cohorts were predominantly males (78.3% vs. 76.2%). Amongst the Study Cohort, 77.5% were p16-positive, of whom 98.4% were down staged in the 8th Edition. These early-stage patients showed OS improvement for those treated with chemoradiation, compared to radiation alone (85.8% vs. 73.1%, p = 0.05). OpSCC incidence is increasing in BC. The addition of chemotherapy to radiotherapy may portend a benefit in OS even for early-stage p16-positive OpSCC. Additional research is necessary to assess the safety of treatment de-escalation even among early-stage disease.
Sections du résumé
BACKGROUND
BACKGROUND
The revised 8th Edition American Joint Committee on Cancer (AJCC) Head and Neck Staging Manual distinguishes HPV-mediated from non-HPV-mediated oropharyngeal cancer (OpSCC). The objective was to analyze OpSCC treatment modalities and outcomes.
METHODS
METHODS
A retrospective study of OpSCC patients treated with radiotherapy or chemoradiotherapy between January 1st, 2000, and December 31st, 2008, as identified from the BC Cancer Registry. All patients received treatment at cancer clinics and had at least 5 years follow-up post-treatment. A total of 1259 OpSCC patients were identified. After initial chart reviews, 288 patients were excluded from further analysis and the majority (n = 198) was due to not receiving curative treatment. Based on the availability of formalin-fixed, paraffin-embedded (FFPE) tissue, patients were divided into two cohorts: Study Cohort (FFPE available, n = 244) and General Cohort (FFPE unavailable, n = 727). The Study Cohort was restaged according to AJCC 8th Edition based on p16 immunohistochemistry status. Kaplan-Meier analysis was used to estimate the 5-year overall survival (OS), disease-specific survival (DSS), and locoregional recurrence-free survival (LFS).
RESULTS
RESULTS
Among 971 patients, OpSCC age-adjusted incidence rate was observed to have increased from 2.1 to 3.5 per 100,000 between 2000 and 2008. The General Cohort was relatively older than the Study Cohort (60.1 ± 10.5 vs. 57.3 ± 9.4), but both cohorts were predominantly males (78.3% vs. 76.2%). Amongst the Study Cohort, 77.5% were p16-positive, of whom 98.4% were down staged in the 8th Edition. These early-stage patients showed OS improvement for those treated with chemoradiation, compared to radiation alone (85.8% vs. 73.1%, p = 0.05).
CONCLUSIONS
CONCLUSIONS
OpSCC incidence is increasing in BC. The addition of chemotherapy to radiotherapy may portend a benefit in OS even for early-stage p16-positive OpSCC. Additional research is necessary to assess the safety of treatment de-escalation even among early-stage disease.
Identifiants
pubmed: 35525912
doi: 10.1186/s12885-022-09515-2
pii: 10.1186/s12885-022-09515-2
pmc: PMC9077931
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
513Subventions
Organisme : Terry Fox Research Institute
ID : 2009-24
Informations de copyright
© 2022. The Author(s).
Références
Cochrane Database Syst Rev. 2018 Dec 14;12:CD012939
pubmed: 30550641
Oral Oncol. 2018 Sep;84:82-87
pubmed: 30115481
Cancer. 2018 Feb 15;124(4):717-726
pubmed: 29243245
Cancer Metastasis Rev. 2017 Sep;36(3):449-461
pubmed: 28812214
Lancet. 2019 Jan 5;393(10166):40-50
pubmed: 30449625
N Engl J Med. 2010 Jul 1;363(1):24-35
pubmed: 20530316
J Clin Oncol. 2021 Mar 20;39(9):956-965
pubmed: 33507809
JAMA. 2012 Feb 15;307(7):693-703
pubmed: 22282321
J Surg Oncol. 2008 Jun 15;97(8):701-7
pubmed: 18493921
BMC Cancer. 2020 Feb 14;20(1):125
pubmed: 32059705
JAMA Otolaryngol Head Neck Surg. 2014 May;140(5):441-7
pubmed: 24652023
Oral Oncol. 2019 Aug;95:170-177
pubmed: 31345387
Head Neck. 2018 Mar;40(3):457-466
pubmed: 28990257
Int J Radiat Oncol Biol Phys. 2019 Aug 1;104(5):1017-1027
pubmed: 30953712
Cancer Res. 2015 Jun 15;75(12):2468-77
pubmed: 25873485
CA Cancer J Clin. 2015 Sep-Oct;65(5):401-21
pubmed: 26215712
J Clin Oncol. 2013 Feb 10;31(5):543-50
pubmed: 23295795
Annu Rev Pathol. 2009;4:49-70
pubmed: 18729723
Ann Oncol. 2018 May 1;29(5):1273-1279
pubmed: 29438466
J Clin Oncol. 2011 Nov 10;29(32):4294-301
pubmed: 21969503
Oral Oncol. 2017 Oct;73:152-159
pubmed: 28939068
Oral Oncol. 2014 Sep;50(9):771-9
pubmed: 24932529
Lancet. 2019 Jan 5;393(10166):51-60
pubmed: 30449623
J Clin Oncol. 2013 Dec 20;31(36):4550-9
pubmed: 24248688