Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2019

01-02-2019 | Head and Neck Oncology

Does p16+ Predict a Favorable Prognosis for Oropharyngeal Cancer? Risk Factors for Treatment Failure for Patients Who Underwent Surgery-Based Therapy

Authors: Young Min Park, MD, PhD, Min Seok Kang, MD, Yoon Woo Koh, MD, PhD, Eun Chang Choi, MD, PhD, Se-Heon Kim, MD, PhD

Published in: Annals of Surgical Oncology | Issue 2/2019

Login to get access

Abstract

Background

This study aimed to identify prognostic clinicopathologic factors that could predict treatment failure and to analyze clinical data from p16+ oropharyngeal squamous cell carcinoma (OPSCC) patients who underwent surgery.

Methods

Data from p16+ OPSCC patients who underwent surgery at Severance Hospital of Yonsei University were retrospectively reviewed.

Results

The average smoking history was 14.6 pack-years (range 0–94 pack-years). Of the 188 patients, 73 (38.8%) underwent transoral robotic surgery (TORS) for surgical treatment of their primary lesions, and the remaining 115 patients (61.2%) underwent conventional surgery. Extracapsular nodal spread was detected in 87 patients (46.3%). At histologic examination, 67 patients (35.6%) showed positive surgical margins, and 121 patients (64.4%) had negative surgical margins. Postoperative adjuvant treatment was performed for 167 patients (88.8%). During the follow-up period, there were 18 recurrences including 2 local recurrences, 10 regional recurrences, and 6 distant metastases. During the study period, 17 deaths occurred. The univariate analysis showed that the American Joint Committee on Cancer (AJCC) 8th-edition staging system, lymphovascular invasion, more than four metastatic lymph nodes, and a smoking history of more than 10 pack-years were significantly associated with treatment failure. In the multivariate analysis, only the AJCC 8th-edition staging system was significantly associated with the patient’s survival.

Conclusion

Surgical treatment methods including TORS for p16+ OPSCC patients showed excellent oncologic results, and many previously known clinicopathologic factors did not show a significant relationship with patient prognosis. Only the newly revised AJCC 8th-edition staging system showed a significant relationship with patient survival, and this should be considered in the setting of p16+ OPSCC treatment guidelines in the future.
Literature
1.
Chaturvedi AK, Engels EA, Anderson WF, Gillison ML. Incidence trends for human papillomavirus-related and -unrelated oral squamous cell carcinomas in the United States. J Clin Oncol. 2008;26:612–9.CrossRefPubMed
2.
3.
Sturgis EM, Ang KK. The epidemic of HPV-associated oropharyngeal cancer is here: is it time to change our treatment paradigms? J Natl Compr Canc Netw. 2011;9:665–73.CrossRefPubMed
4.
Nguyen NP, Ly BH, Betz M, Vinh-Hung V. Importance of age as a prognostic factor for tonsillar carcinoma. Ann Surg Oncol. 2010;17:2570–7.CrossRefPubMed
5.
Panwar A, Batra R, Lydiatt WM, Ganti AK. Human papilloma virus positive oropharyngeal squamous cell carcinoma: a growing epidemic. Cancer Treat Rev. 2014;40:215–9.CrossRefPubMed
6.
Smith EM, Wang D, Rubenstein LM, Morris WA, Turek LP, Haugen TH. Association between p53 and human papillomavirus in head and neck cancer survival. Cancer Epidemiol Biomark Prev. 2008;17:421–7.CrossRef
7.
Ang KK, Sturgis EM. Human papillomavirus as a marker of the natural history and response to therapy of head and neck squamous cell carcinoma. Semin Radiat Oncol. 2012;22:128–42.CrossRefPubMed
8.
Granata R, Miceli R, Orlandi E, et al. Tumor stage, human papillomavirus, and smoking status affect the survival of patients with oropharyngeal cancer: an Italian validation study. Ann Oncol. 2012;23:1832–7.CrossRefPubMed
9.
10.
Rietbergen MM, Brakenhoff RH, Bloemena E, et al. Human papillomavirus detection and comorbidity: critical issues in selection of patients with oropharyngeal cancer for treatment de-escalation trials. Ann Oncol. 2013;24:2740–5.CrossRefPubMed
11.
O’Sullivan B, Huang SH, Su J, Garden AS, Sturgis EM, Dahlstrom K, 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;17:440–51.CrossRefPubMed
12.
Haughey BH, Sinha P, Kallogjeri D, Goldberg RL, Lewis JS Jr, Piccirillo JF, et al. Pathology-based staging for HPV-positive squamous carcinoma of the oropharynx. Oral Oncol. 2016;62:11–9.CrossRefPubMedPubMedCentral
13.
Cohen MA, Weinstein GS, O’Malley BW Jr, Feldman M, Quon H. Transoral robotic surgery and human papillomavirus status: oncologic results. Head Neck. 2011;33:573–80.CrossRefPubMed
14.
Weinstein GS, O’Malley BW Jr, Cohen MA, Quon H. Transoral robotic surgery for advanced oropharyngeal carcinoma. Arch Otolaryngol Head Neck Surg. 2010;136:1079–85.CrossRefPubMed
15.
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;31:543–50.CrossRefPubMed
16.
Kaczmar JM, Tan KS, Heitjan DF, et al. HPV-related oropharyngeal cancer: risk factors for treatment failure in patients managed with primary transoral robotic surgery. Head Neck. 2016;38:59–65.CrossRefPubMed
Metadata
Title
Does p16+ Predict a Favorable Prognosis for Oropharyngeal Cancer? Risk Factors for Treatment Failure for Patients Who Underwent Surgery-Based Therapy
Authors
Young Min Park, MD, PhD
Min Seok Kang, MD
Yoon Woo Koh, MD, PhD
Eun Chang Choi, MD, PhD
Se-Heon Kim, MD, PhD
Publication date
01-02-2019
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 2/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-6806-x

Other articles of this Issue 2/2019

Annals of Surgical Oncology 2/2019 Go to the issue

ASO Author Reflections

ASO Author Reflections: T1b Penile Cancer: An Alarm to Improve Treatment

Pancreatic Tumors

Significance of 18F-Fluorodeoxyglucose (FDG) Uptake in Response to Chemoradiotherapy for Pancreatic Cancer

Gastrointestinal Oncology

The Controlling Nutritional Status Score Serves as a Predictor of Short- and Long-Term Outcomes for Patients with Stage 2 or 3 Gastric Cancer: Analysis of a Multi-institutional Data Set

Colorectal Cancer

Learning by Example: An International Perspective on Reflex-Testing for Lynch Syndrome

Hepatobiliary Tumors

Hepatic Angiosarcoma: A Multi-institutional, International Experience with 44 Cases

Breast Oncology

Can Patients with Multiple Breast Cancers in the Same Breast Avoid Mastectomy by Having Multiple Lumpectomies to Achieve Equivalent Rates of Local Breast Cancer Recurrence? Response to the Preliminary Alliance 11102 Trial Report