Primary treatment for oropharyngeal squamous cell carcinoma in Alberta, Canada: A population‐based study

Hobbs, Amy; Brockton, Nigel T.; Matthews, T. Wayne; Chandarana, Shamir; Bose, Pinaki; Guggisberg, Kelly; Fick, Gordon H.; Dort, Joseph C.

doi:10.1002/hed.24889

Cited by 6 publications

(15 citation statements)

References 53 publications

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“…We also found that HPV status was significantly correlated to sex and age of patients. About sex, HPV positive estimates were substantially higher in men than in women in our cohort, different from European cohort in other studies [ 3 – 7 ]. Additionally, we also found that HPV positive estimates were substantially higher in 46–55 ages.…”

Section: Discussioncontrasting

confidence: 99%

“…Before HPV positive as a new risk factor for HNSCC was found, many risk factors had been reported, including tobacco, poor oral hygiene, and alcohol [ 5 , 6 ]. Then the prevalence of HPV-related HNSCC, especially oropharyngeal squamous cell carcinomas (OPSCC), was largely observed in many populations in Western Europe, United States, and Australia [ 3 – 7 ]. Nonetheless, the prevalence, prognostic, significance, and correlations of high-risk HPV infection in OPSCCs in China cohort, accounting for 1/4 of the global population, remain blurry.…”

Section: Introductionmentioning

confidence: 99%

“…High-risk human papillomavirus (HPV) infection causes the increase of OPSCC [ 8 ]. Many studies have shown that the prevalence of HPV-related OPSCC has been evaluated to range from 45 to 90% [ 3 – 7 ]. Moreover, a dominant subtype of HPV16 is thought to represent 90% of HPV-related OPSCC.…”

Section: Introductionmentioning

confidence: 99%

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Association of p16 as Prognostic Factors for Oropharyngeal Cancer: Evaluation of p16 in 1470 Patients for a 16 Year Study in Northeast China

Meng

Miao

Chen

et al. 2018

BioMed Research International

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Human papillomavirus (HPV) is an etiological risk factor for oropharyngeal squamous cell carcinomas (OPSCC). Our study investigates the prevalence, prognostic, and clinicopathologic features of HPV-related oropharyngeal cancer in Northeast China and elucidates the involvement of p16 in the tumorigenesis and progression of OPSCC. Specimens from 1470 OPSCC patients collected from 2000 to 2016 were analyzed using the status of HPV by polymerase chain reaction (PCR) and p16 immunohistochemistry. Overexpression of p16 was observed in 81 (5.51%) of the 1470 cases, and HPV positive was present in 78 cases (5.31%) of the 1470 cases. HPV positive and p16 overexpression have a good concordance. However, we found that the etiological fraction of HPV in cancers of the OPSCCs was obviously lower in Northeast China than other cohorts previously reported. Interestingly, nearly 89% of patients with p16 expression were smokers, and nearly 70% of patients with p16 expression had a history of alcohol. Our study also demonstrates that p16 expression is significantly associated with early stage primary OPSCCs and the patients with p16 expression tend to show better survival following surgery and radiotherapy.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of p16 as Prognostic Factors for Oropharyngeal Cancer: Evaluation of p16 in 1470 Patients for a 16 Year Study in Northeast China

Meng

Miao

Chen

et al. 2018

BioMed Research International

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“…Unfortunately, this study was closed soon after opening due to a lack of patient accrual, potentially attributed to a decline in the incidence of HPV-negative HN cancers. 12,13 Since this time, retrospective institutional studies [14][15][16][17][18] and a 2015 systematic review 19 suggest that primary surgery is associated with improved survival, although most studies did not specifically examine cT1-2N1-2b cancers. The biological hypothesis for these findings is a decreased sensitivity to RT by HPV-negative tumors.…”

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confidence: 99%

Revisiting the Radiation Therapy Oncology Group 1221 Hypothesis: Treatment for Stage III/IV HPV‐Negative Oropharyngeal Cancer

Jacobs

Torabi

Park

et al. 2020

Otolaryngol.--head neck surg.

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Objective In 2014, the Radiation Therapy Oncology Group 1221 trial was initiated to analyze whether surgery with risk-based radiation therapy or chemoradiation therapy was superior to chemoradiation therapy alone in patients with clinically staged T1-2N1-2bM0 HPV-negative oropharyngeal squamous cell carcinoma. However, the study was prematurely terminated. Given the lack of a randomized controlled trial, we retrospectively approached the same question using large national cancer databases. Study Design Retrospective cohort study. Setting The National Cancer Database and Surveillance, Epidemiology, and End Results (SEER) program from 2010 to 2016. Methods We identified 3004 patients in the National Cancer Database and 670 patients in the SEER database. Statistical techniques included Kaplan-Meier survival analysis, binary and multinomial logistic regressions, Cox proportional hazard regressions, and inverse propensity score weighting. Results On weighted multivariable Cox regression, patients recommended to receive frontline surgery had improved overall survival as compared with those recommended to receive chemoradiation therapy alone (hazard ratio [HR], 0.77; 95% CI, 0.68-0.86). On post hoc multivariable analysis based on therapy actually received, frontline surgery with adjuvant chemoradiation therapy was associated with improved overall survival (HR, 0.59; 95% CI, 0.50-0.71) as compared with chemoradiation therapy without surgery. Analysis of the SEER cohort revealed improved overall survival (HR, 0.69; 95% CI, 0.54-0.87) and head and neck cancer–specific survival (HR, 0.59; 95% CI, 0.41-0.84) in patients recommended to receive frontline surgery over chemoradiation therapy alone. Conclusion Our findings support the use of surgery with risk-based addition of adjuvant therapy in patients with cT1-2N1-2bM0 HPV-negative oropharyngeal cancer.

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“…This is similar to previous literature examining how final pathology influences adjuvant treatment and survival. 10-14…”

Section: Discussionmentioning

confidence: 99%

Human Papillomavirus–Negative Oropharyngeal Cancer Survival Outcomes Based on Primary Treatment: National Cancer Database Analysis

Shama

Al‐Qurayshi

Dahl

et al. 2021

Otolaryngol.--head neck surg.

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Objective To compare survival outcomes between primary surgery and primary radiation therapy (RT) in patients with human papillomavirus (HPV)–negative oropharyngeal squamous cell carcinoma (OPSCC). Study Design A retrospective observational cohort study. Setting National Cancer Database. Methods A National Cancer Database review was conducted of 2635 patients with HPV-negative OPSCC who underwent surgery or RT ± chemotherapy between 2010 and 2014. Univariate analysis was performed on all variables and entered into a multivariate model. The main outcome was overall survival (OS). Results A total of 2635 patients with HPV-negative OPSCC were organized into 4 groups based on cancer staging. In group 1 (T1-2 N0-1; n = 774), up-front surgery had significantly better 5-year OS (76.2%) than RT (56.8%; adjusted hazard ratio [aHR], 1.76; P = .009; 95% CI, 1.15-2.69) and chemoradiation therapy (CRT; 69.5%; aHR, 1.56; P = .019; 95% CI, 1.08-2.26). In group 2 (T3-4 N0-1; n = 327), no significant difference existed between surgery and CRT (5-year OS, 51.3% vs 52.4%; aHR, 0.96; P = .88; 95% CI, 0.54-1.69). In group 3a (T1-2 N2-3; n = 807), surgery with adjuvant treatment showed significantly better 5-year OS than CRT (78.6% vs 68.8%; aHR, 1.51; P = .027; 95% CI, 1.05-2.18). In group 3b (T3-4 N2-3; n = 737), surgery with adjuvant treatment was not statistically associated with better 5-year OS as compared with CRT (61.0% vs 43.7%; aHR, 1.53; P = .06; 95% CI, 0.98-2.39). Conclusion Primary surgery may provide improved survival outcomes in many cases of HPV-negative OPSCCs. These data should be used in weighing treatment options and may serve as a basis to better delineate treatment algorithms for HPV-negative disease.

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Primary treatment for oropharyngeal squamous cell carcinoma in Alberta, Canada: A population‐based study

Abstract: Patients with p16-positive oropharyngeal SCC had similar outcomes regardless of treatment. Patients with p16-negative tumors may benefit from primary surgery with postoperative adjuvant therapy.

Cited by 6 publications

References 53 publications

Association of p16 as Prognostic Factors for Oropharyngeal Cancer: Evaluation of p16 in 1470 Patients for a 16 Year Study in Northeast China

Association of p16 as Prognostic Factors for Oropharyngeal Cancer: Evaluation of p16 in 1470 Patients for a 16 Year Study in Northeast China

Revisiting the Radiation Therapy Oncology Group 1221 Hypothesis: Treatment for Stage III/IV HPV‐Negative Oropharyngeal Cancer

Human Papillomavirus–Negative Oropharyngeal Cancer Survival Outcomes Based on Primary Treatment: National Cancer Database Analysis

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