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A comparison of timing and patterns of treatment failure, and survival outcomes after progression between HPV+ and HPV- patients undergoing chemoradiation for oropharyngeal squamous cell carcinomas.
Laxague, Francisco; Zeng, Peter Y F; Zabihi, Dorsa; Fnais, Naif; Alshahrani, Mohammed; Fung, Kevin; MacNeil, Danielle; Mendez, Adrian; Yoo, John; Mymryk, Joseph S; Barrett, John W; Palma, David A; Nichols, Anthony C.
Afiliación
  • Laxague F; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Center Children's Hospital, London, Ontario, Canada.
  • Zeng PYF; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Center Children's Hospital, London, Ontario, Canada.
  • Zabihi D; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Center Children's Hospital, London, Ontario, Canada.
  • Fnais N; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Center Children's Hospital, London, Ontario, Canada.
  • Alshahrani M; Department of Otolaryngology - Head and Neck Surgery, King Saud University, Riyadh, Saudi Arabia.
  • Fung K; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Center Children's Hospital, London, Ontario, Canada.
  • MacNeil D; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Center Children's Hospital, London, Ontario, Canada.
  • Mendez A; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Center Children's Hospital, London, Ontario, Canada.
  • Yoo J; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Center Children's Hospital, London, Ontario, Canada.
  • Mymryk JS; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Center Children's Hospital, London, Ontario, Canada.
  • Barrett JW; Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada.
  • Palma DA; Department of Microbiology & Immunology, University of Western Ontario, London, Ontario, Canada.
  • Nichols AC; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Center Children's Hospital, London, Ontario, Canada.
Head Neck ; 46(3): 503-512, 2024 03.
Article en En | MEDLINE | ID: mdl-38100227
ABSTRACT

BACKGROUND:

We aimed to analyze and compare the timing and patterns of treatment failure, and survival after progression between HPV-positive (HPV+) and HPV-negative (HPV-) patients undergoing chemoradiation for oropharyngeal squamous cell carcinomas (OPSCC).

METHODS:

A retrospective review was performed of all patients undergoing primary chemoradiation for OPSCC between 2008 and 2021. Demographic and clinical data were collected. Kaplan-Meier estimates for overall survival (OS), and time to recurrence/metastases (TTR) were compared using the log-rank test, with Cox regression used for multivariable modeling comparing HPV+ and HPV- patients.

RESULTS:

HPV- patients developed recurrence or metastases at earlier time points than HPV+ patients (8.8 vs. 15.2 months, p < 0.05), due to earlier local/locoregional recurrence and distant metastases, but not isolated regional recurrences. HPV- distant metastases exclusively occurred in a single organ, most commonly the lungs or bone, while HPV+ metastases frequently had multi-organ involvement in a wide variety of locations (p < 0.05). Once progression (recurrence/metastases) was diagnosed, HPV+ patients experienced superior survival to HPV- patients on univariate and multivariate analysis, largely due to improved outcomes after treatment of local/locoregional recurrences (p < 0.05). There were no differences in survival after isolated regional recurrences or distant metastases.

CONCLUSION:

HPV+ OPSCC patients relapse later compared to HPV- patients in local/locoregional and distant sites. HPV+ patients with local/locoregional recurrence experience superior survival after recurrence, which does not hold true for isolated regional recurrences or distant metastases. These data can be useful to inform prognosis and guide treatment decisions in patients with recurrent OPSCC.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Células Escamosas / Neoplasias Orofaríngeas / Infecciones por Papillomavirus / Neoplasias de Cabeza y Cuello Límite: Humans Idioma: En Revista: Head Neck Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Células Escamosas / Neoplasias Orofaríngeas / Infecciones por Papillomavirus / Neoplasias de Cabeza y Cuello Límite: Humans Idioma: En Revista: Head Neck Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos