Hostname: page-component-77f85d65b8-pztms Total loading time: 0 Render date: 2026-03-29T02:13:08.071Z Has data issue: false hasContentIssue false
  • English
  • Français

Long-term survival outcomes in patients with surgically treated oropharyngeal cancer and defined human papilloma virus status

Published online by Cambridge University Press:  08 November 2016

O T Dale ,
S Sood ,
K A Shah ,
C Han ,
D Rapozo ,
H Mehanna  and
S C Winter
O T Dale*
Affiliation:
Head and Neck Department, John Radcliffe and Churchill Hospitals, Oxford, UK
S Sood
Affiliation:
ENT Department, Great Western Hospital, Swindon, UK
K A Shah
Affiliation:
Head and Neck Department, John Radcliffe and Churchill Hospitals, Oxford, UK
C Han
Affiliation:
Department of Oncology, University of Oxford, UK
D Rapozo
Affiliation:
Institute of Head and Neck Studies and Education, University of Birmingham, UK
H Mehanna
Affiliation:
Institute of Head and Neck Studies and Education, University of Birmingham, UK
S C Winter
Affiliation:
Head and Neck Department, John Radcliffe and Churchill Hospitals, Oxford, UK
*
Address for correspondence: Mr Oliver T Dale, ENT Department, St Michael's Hospital Bristol, Southwell St, Bristol BS2 8EG, UK E-mail: otdale@doctors.net.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

This study investigated long-term survival outcomes in surgically treated oropharyngeal cancer patients with known human papilloma virus status.

Methods:

A case note review was performed of all patients undergoing primary surgery for oropharyngeal cancer in a single centre over a 10-year period. Human papilloma virus status was determined via dual modality testing. Associations between clinicopathological variables and survival were identified using a log-rank test.

Results:

Of the 107 cases in the study, 40 per cent (n = 41) were human papilloma virus positive. The positive and negative predictive values of p16 immunohistochemistry for human papilloma virus status were 57 per cent and 100 per cent, respectively. At a mean follow up of 59.5 months, 5-year overall and disease-specific survival estimates were 78 per cent and 69 per cent, respectively. Human papilloma virus status (p = 0.014), smoking status (p = 0.021) and tumour stage (p = 0.03) were significant prognostic indicators.

Conclusion:

The long-term survival rates in surgically treated oropharyngeal cancer patients were comparable to other studies. Variables including human papilloma virus status and tumour stage were associated with survival in patients treated with primary surgery; however, nodal stage and presence of extracapsular spread were non-prognostic.

Keywords

Oropharyngeal NeoplasmsSquamous Cell CarcinomaHead And Neck Neoplasms

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 11 , November 2016 , pp. 1048 - 1053
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

1 Mehanna, H, Jones, TM, Gregoire, V, Ang, KK. Oropharyngeal carcinoma related to human papillomavirus. BMJ 2010;340:c1439 Google Scholar
2 Chaturvedi, AK, Engels, EA, Pfeiffer, RM, Hernandez, BY, Xiao, W, Kim, E et al. Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol 2011;29:4294–301Google Scholar
3 D'Souza, G, Kreimer, AR, Viscidi, R, Pawlita, M, Fakhry, C, Koch, WM et al. Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med 2007;356:1944–56Google Scholar
4 Adelstein, DJ, Rodriguez, CP. Human papillomavirus: changing paradigms in oropharyngeal cancer. Curr Oncol Rep 2010;12:115–20Google Scholar
5 Howlader, N, Noone, AM, Krapcho, M, Garshell, J, Neyman, N, Altekruse, SF et al. , eds. SEER Cancer Statistics Review, 1975-2010. Bethesda, MD: National Cancer Institute, 2012 Google Scholar
6 Rieckmann, T, Tribius, S, Grob, TJ, Meyer, F, Busch, CJ, Petersen, C et al. HNSCC cell lines positive for HPV and p16 possess higher cellular radiosensitivity due to an impaired DSB repair capacity. Radiother Oncol 2013;107:242–6Google Scholar
7 Leemans, CR, Braakhuis, BJ, Brakenhoff, RH. The molecular biology of head and neck cancer. Nat Rev Cancer 2011;11:9–22 Google Scholar
8 Snijders, PJ, Cromme, FV, van den Brule, AJ, Schrijnemakers, HF, Snow, GB, Meijer, CJ et al. Prevalence and expression of human papillomavirus in tonsillar carcinomas, indicating a possible viral etiology. Int J Cancer 1992;51:845–50CrossRefGoogle ScholarPubMed
9 Chen, AY, Zhu, J, Fedewa, S. Temporal trends in oropharyngeal cancer treatment and survival, 1998–2009. Laryngoscope 2014;124:131–8Google Scholar
10 National Head and Neck Cancer Audit, 2012. In: http://digital.nhs.uk/catalogue/PUB11015/clin-audi-supp-prog-head-neck-dahn-11-12-rep0.pdf [5 September 2016]Google Scholar
11 Ang, KK, Harris, J, Wheeler, R, Weber, R, Rosenthal, DI, Nguyen-Tan, PF et al. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med 2010;363:24–35 Google Scholar
12 Evans, M, Newcombe, R, Fiander, A, Powell, J, Rolles, M, Thavaraj, S et al. Human papillomavirus-associated oropharyngeal cancer: an observational study of diagnosis, prevalence and prognosis in a UK population. BMC Cancer 2013;13:220Google Scholar
13 Westra, WH. The changing face of head and neck cancer in the 21st century: the impact of HPV on the epidemiology and pathology of oral cancer. Head Neck Pathol 2009;3:78–81 Google Scholar
14 Schlecht, NF, Brandwein-Gensler, M, Nuovo, GJ, Li, M, Dunne, A, Kawachi, N et al. A comparison of clinically utilized human papillomavirus detection methods in head and neck cancer. Mod Pathol 2011;24:1295–305Google Scholar
15 Parsons, JT, Mendenhall, WM, Stringer, SP, Amdur, RJ, Hinerman, RW, Villaret, DB et al. Squamous cell carcinoma of the oropharynx: surgery, radiation therapy, or both. Cancer 2002;94:2967–80Google Scholar
16 O'Connell, D, Seikaly, H, Murphy, R, Fung, C, Cooper, T, Knox, A et al. Primary surgery versus chemoradiotherapy for advanced oropharyngeal cancers: a longitudinal population study. J Otolaryngol Head Neck Surg 2013;42:31 Google Scholar
17 Zhen, W, Karnell, LH, Hoffman, HT, Funk, GF, Buatti, JM, Menck, HR. The National Cancer Data Base report on squamous cell carcinoma of the base of tongue. Head Neck 2004;26:660–74Google Scholar
18 Chen, MM, Roman, SA, Kraus, DH, Sosa, JA, Judson, BL. Transoral robotic surgery: a population-level analysis. Otolaryngol Head Neck Surg 2014;150:968–75Google Scholar
19 de Almeida, JR, Li, R, Magnuson, JS, Smith, RV, Moore, E, Lawson, G et al. Oncologic outcomes after transoral robotic surgery: a multi-institutional study. JAMA Otolaryngol Head Neck Surg 2015;141:1043–51CrossRefGoogle ScholarPubMed
20 Bastos de Souza, TR, Pinto, CA, da Cunha Mercante, AM, Nishimoto, IN, Brasilino de Carvalho, M, Kowalski, LP. Long-term results of surgical treatment for advanced oropharyngeal squamous cell carcinoma. Head Neck 2014;36:1146–54Google Scholar
21 Haughey, BH, Sinha, P. Prognostic factors and survival unique to surgically treated p16+ oropharyngeal cancer. Laryngoscope 2012;122(suppl 2):S13–33 Google Scholar
22 Maxwell, JH, Ferris, RL, Gooding, W, Cunningham, D, Mehta, V, Kim, S et al. Extracapsular spread in head and neck carcinoma: impact of site and human papillomavirus status. Cancer 2013;119:3302–8Google Scholar