Oropharyngeal squamous cell carcinoma: Prognostic factors for development of distant metastases and oncological outcomes.
distant metastasis
human papillomavirus
lung metastasis
oropharyngeal squamous cell carcinoma
overall survival
Journal
Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
revised:
12
02
2023
received:
13
12
2022
accepted:
13
03
2023
medline:
12
5
2023
pubmed:
12
4
2023
entrez:
11
4
2023
Statut:
ppublish
Résumé
Distant metastasis (DM) development in Oropharyngeal Squamous Cell Carcinoma (OPSCC) represents an important prognostic factor. The identification of a phenotype of metastatic patients may better define therapeutic and follow-up programs. We included 408 patients with OPSCC, non-metastatic at the time of diagnosis, and treated with curative intent. The Overall Survival (OS) analyses were performed and the impact of developing DM on survival was analyzed through Cox proportional-hazard regression model. 57 (14%) patients develop DM. 302 (74%) were p16+ OPSCC and 35 of them experienced DM. Advanced clinical stage, smoking, p16-status, response to primary treatment, and loco-regional relapse influence the DM rate. Only in the p16+ group, DM onset results in a greater impact on OS (p < 0.0001). Lung metastases have a better OS compared to non-pulmonary ones (p = 0.049). This retrospective study shows a possible stratification of OPSCC patients based on the risk of the development of DMs.
Sections du résumé
BACKGROUND
Distant metastasis (DM) development in Oropharyngeal Squamous Cell Carcinoma (OPSCC) represents an important prognostic factor. The identification of a phenotype of metastatic patients may better define therapeutic and follow-up programs.
METHODS
We included 408 patients with OPSCC, non-metastatic at the time of diagnosis, and treated with curative intent. The Overall Survival (OS) analyses were performed and the impact of developing DM on survival was analyzed through Cox proportional-hazard regression model.
RESULTS
57 (14%) patients develop DM. 302 (74%) were p16+ OPSCC and 35 of them experienced DM. Advanced clinical stage, smoking, p16-status, response to primary treatment, and loco-regional relapse influence the DM rate. Only in the p16+ group, DM onset results in a greater impact on OS (p < 0.0001). Lung metastases have a better OS compared to non-pulmonary ones (p = 0.049).
CONCLUSION
This retrospective study shows a possible stratification of OPSCC patients based on the risk of the development of DMs.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1406-1417Informations de copyright
© 2023 Wiley Periodicals LLC.
Références
Faraji F, Rettig EM, Tsai H, et al. The prevalence of human papillomavirus in oropharyngeal cancer is increasing regardless of sex or race, and the influence of sex and race on survival is modified by human papillomavirus tumor status. Cancer. 2019;125(5):761-769. doi:10.1002/cncr.31841
Carlander AF, Jakobsen KK, Bendtsen SK, et al. A contemporary systematic review on repartition of HPV-positivity in oropharyngeal cancer worldwide. Viruses. 2021;13(7):1326. doi:10.3390/v13071326
Chaturvedi AK, Engels EA, Pfeiffer RM, et al. Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol. 2011;29(32):4294-4301. doi:10.1200/JCO.2011.36.4596
Ang KK, Harris J, Wheeler R, et al. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med. 2010;363(1):24-35. doi:10.1056/NEJMoa0912217
Craig SG, Anderson LA, Schache AG, et al. Recommendations for determining HPV status in patients with oropharyngeal cancers under TNM8 guidelines: a two-tier approach. Br J Cancer. 2019;120(8):827-833. doi:10.1038/s41416-019-0414-9
Fakhry C, Zhang Q, Nguyen-Tan PF, et al. Human papillomavirus and overall survival after progression of oropharyngeal squamous cell carcinoma. J Clin Oncol. 2014;32(30):3365-3373. doi:10.1200/JCO.2014.55.1937
O'Sullivan B, Huang SH, Su J, et al. Development and validation of a staging system for HPV-related oropharyngeal cancer by the international collaboration on oropharyngeal cancer network for staging (ICON-S): a multicentre cohort study. Lancet Oncol. 2016;17(4):440-451. doi:10.1016/S1470-2045(15)00560-4
Huang SH, Xu W, Waldron J, et al. Refining American Joint Committee on Cancer/Union for International Cancer Control TNM stage and prognostic groups for human papillomavirus-related oropharyngeal carcinomas. J Clin Oncol. 2015;33(8):836-845. doi:10.1200/JCO.2014.58.6412
Machczyński P, Majchrzak E, Niewinski P, Marchlewska J, Golusiński W. A review of the 8th edition of the AJCC staging system for oropharyngeal cancer according to HPV status. Eur Arch Otorhinolaryngol. 2020;277(9):2407-2412. doi:10.1007/s00405-020-05979-9
Lewis JS, Beadle B, Bishop JA, et al. Human papillomavirus testing in head and neck carcinomas: guideline from the College of American Pathologists. Arch Pathol Lab Med. 2018;142(5):559-597. doi:10.5858/arpa.2017-0286-CP
Huang SH, Perez-Ordonez B, Weinreb I, et al. Natural course of distant metastases following radiotherapy or chemoradiotherapy in HPV-related oropharyngeal cancer. Oral Oncol. 2013;49(1):79-85. doi:10.1016/j.oraloncology.2012.07.015
O'Sullivan B, Huang SH, Siu LL, et al. Deintensification candidate subgroups in human papillomavirus-related oropharyngeal cancer according to minimal risk of distant metastasis. J Clin Oncol. 2013;31(5):543-550. doi:10.1200/JCO.2012.44.0164
Lin BM, Wang H, D'Souza G, et al. Long-term prognosis and risk factors among patients with HPV-associated oropharyngeal squamous cell carcinoma: risk factors HPV-head and neck cancers. Cancer. 2013;119(19):3462-3471. doi:10.1002/cncr.28250
Weinberger PM, Yu Z, Haffty BG, et al. Molecular classification identifies a subset of human papillomavirus-associated oropharyngeal cancers with favorable prognosis. J Clin Oncol. 2006;24(5):736-747. doi:10.1200/JCO.2004.00.3335
Sinha P, Thorstad WT, Nussenbaum B, et al. Distant metastasis in p16-positive oropharyngeal squamous cell carcinoma: a critical analysis of patterns and outcomes. Oral Oncol. 2014;50(1):45-51. doi:10.1016/j.oraloncology.2013.10.007
Trosman SJ, Koyfman SA, Ward MC, et al. Effect of human papillomavirus on patterns of distant metastatic failure in oropharyngeal squamous cell carcinoma treated with chemoradiotherapy. JAMA Otolaryngol Neck Surg. 2015;141(5):457-462. doi:10.1001/jamaoto.2015.136
Jaber JJ, Murrill L, Clark JI, Johnson JT, Feustel PJ, Mehta V. Robust differences in p16-dependent oropharyngeal squamous cell carcinoma distant metastasis: implications for targeted therapy. Otolaryngol Neck Surg. 2015;153(2):209-217. doi:10.1177/0194599815581836
Al-Khudari S, Guo S, Chen Y, et al. Solitary dural metastasis at presentation in a patient with untreated human papillomavirus-associated squamous cell carcinoma of the oropharynx: Solitary dural metastasis in HPV+ SCC of the oropharynx. Head Neck. 2014;36(10):E103-E105. doi:10.1002/hed.23589
Brierley JD, Gospodarowicz MK, Wittekind C. Skin tumours. TNM Classification of Malignant Tumours. VIII ed. John Wiley & Sons; 2017.
Beitler JJ, Switchenko JM, Dignam JJ, et al. Smoking, age, nodal disease, T stage, p16 status, and risk of distant metastases in patients with squamous cell cancer of the oropharynx. Cancer. 2019;125(5):704-711. doi:10.1002/cncr.31820
Weller MA, Ward MC, Berriochoa C, et al. Predictors of distant metastasis in human papillomavirus-associated oropharyngeal cancer: distant metastases rates in HPV-positive oropharyngeal cancer. Head Neck. 2017;39(5):940-946. doi:10.1002/hed.24711
Gillison ML, Zhang Q, Jordan R, et al. Tobacco smoking and increased risk of death and progression for patients with p16-positive and p16-negative oropharyngeal cancer. J Clin Oncol. 2012;30(17):2102-2111. doi:10.1200/JCO.2011.38.4099
Teschendorff AE, Yang Z, Wong A, et al. Correlation of smoking-associated DNA methylation changes in buccal cells with DNA methylation changes in epithelial cancer. JAMA Oncol. 2015;1(4):476-485. doi:10.1001/jamaoncol.2015.1053
Schierl M, Patel D, Ding W, et al. Tobacco smoke-induced immunologic changes may contribute to oral carcinogenesis. J Invest Med. 2014;62(2):316-323. doi:10.2310/JIM.0000000000000031
Mirghani H, Lacroix L, Rossoni C, et al. Does smoking alter the mutation profile of human papillomavirus-driven head and neck cancers? Eur J Cancer. 2018;94:61-69. doi:10.1016/j.ejca.2018.02.013
Fleming CW, Ward MC, Woody NM, et al. Identifying an oligometastatic phenotype in HPV-associated oropharyngeal squamous cell cancer: implications for clinical trial design. Oral Oncol. 2021;112:105046. doi:10.1016/j.oraloncology.2020.105046
Goodwin WJ. Distant metastases from oropharyngeal cancer. ORL. 2001;63(4):222-223. doi:10.1159/000055745
Leibel SA, Scott CB, Mohiuddin M, et al. The effect of local-regional control on distant metastatic dissemination in carcinoma of the head and neck: results of an analysis from the RTOG head and neck database. Int J Radiat Oncol. 1991;21(3):549-556. doi:10.1016/0360-3016(91)90669-U
Leeman JE, Li J-G, Pei X, et al. Patterns of treatment failure and Postrecurrence outcomes among patients with locally advanced head and neck squamous cell carcinoma after chemoradiotherapy using modern radiation techniques. JAMA Oncologia. 2017;3(11):1487-1494. doi:10.1001/jamaoncol.2017.0973
Liu C, Mann D, Sinha UK, Kokot NC. The molecular mechanisms of increased radiosensitivity of HPV-positive oropharyngeal squamous cell carcinoma (OPSCC): an extensive review. J Otolaryngol: Head Neck Surg. 2018;47(1):59. doi:10.1186/s40463-018-0302-y
Weissmann T, Höfler D, Hecht M, et al. Oligometastatic head and neck cancer: which patients benefit from radical local treatment of all tumour sites? Radiat Oncol. 2021;16(1):62. doi:10.1186/s13014-021-01790-w
Lievens Y, Guckenberger M, Gomez D, et al. Defining oligometastatic disease from a radiation oncology perspective: an ESTRO-ASTRO consensus document. Radiother Oncol. 2020;148:157-166. doi:10.1016/j.radonc.2020.04.003
Pipkorn P, Sinha P, Kallogjeri D, et al. Outcomes of relapsed human papillomavirus-related oropharyngeal squamous cell carcinoma treated with curative intent. Head Neck. 2019;41(5):1312-1319. doi:10.1002/hed.25557