Περίληψη:
Objectives: HPV16-positive oropharyngeal cancer (OPC) patients experience better outcomes compared to HPV16-negative patients. Currently, strategies for treatment de-escalation are based on HPV status, smoking history and disease stage. However, the appropriate cut-point for smoking and the role of other non-clinical factors in OPC survival remains uncertain. Materials and Methods: We examined factors associated with OPC outcome in 321 patients recruited in a large European multi-center study. Seropositivity for HPV16 E6 was used as a marker of HPV16 positive cancer. Hazard ratios (HR) and confidence intervals (CI) were estimated using Cox proportional models adjusted for potential confounders. Results: Overall 5-year survival following OPC diagnosis was 50%. HPV16-positive OPC cases were at significantly lower risk of death (aHR = 0.51, 95% CI: 0.32–0.80). A significant effect on OPC survival was apparent for female sex (aHR 0.50: 95% CI: 0.29–0.85) and being underweight at diagnosis (aHR: 2.41, 95% CI: 1.38–4.21). A 10 pack year smoking history was not associated with overall survival. Higher stage at diagnosis appeared as the only factor significantly associated with OPC recurrence (aHR: 4.88, 95% CI: 2.12–11.21). Conclusion: This study confirms that HPV16 status is an independent prognostic factor for OPC survival while female sex lowers risk of death and being underweight at diagnosis increases the risk of death. Smoking was not an independent predictor of OPC survival. © 2018 Elsevier Ltd
Συγγραφείς:
Anantharaman, D.
Billot, A.
Waterboer, T.
Gheit, T.
Abedi-Ardekani, B.
Lagiou, P.
Lagiou, A.
Ahrens, W.
Holcátová, I.
Merletti, F.
Kjaerheim, K.
Polesel, J.
Simonato, L.
Alemany, L.
Mena Cervigon, M.
Macfarlane, T.V.
Znaor, A.
Thomson, P.J.
Robinson, M.
Canova, C.
Conway, D.I.
Wright, S.
Healy, C.M.
Toner, M.E.
Pawlita, M.
Tommasino, M.
Brennan, P.
Λέξεις-κλειδιά:
Article; cancer diagnosis; cancer mortality; cancer patient; cancer recurrence; cancer survival; controlled study; Europe; female; human; Human papillomavirus type 16; major clinical study; male; medical history; multicenter study; oropharynx cancer; outcome assessment; overall survival; priority journal; risk factor; smoking; survival prediction; underweight; Alphapapillomavirus; body mass; clinical trial; isolation and purification; middle aged; oropharynx tumor; pathology; retrospective study; survival analysis; tumor recurrence; virology; virus infection, Alphapapillomavirus; Body Mass Index; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Oropharyngeal Neoplasms; Retrospective Studies; Risk Factors; Smoking; Survival Analysis; Tumor Virus Infections
