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Diagnostic Delay in HPV-Related Oropharyngeal Squamous Cell Carcinoma
McGarey Jr., Patrick O.; Hamdi, Osama; Donaldson, Lane; Zhan, Kevin; Crandley, Edwin F.; Wilson, David D.; Sim, Austin J.; Read, Paul W.; Garneau, Jonathan C.; Fedder, Katherine L.; Shonka Jr., David C.; Jameson, Mark J..
Afiliação
  • McGarey Jr., Patrick O.; University of Virginia. Department of Otolaryngology, Head and Neck Surgery. Division of Head and Neck Oncologic and Microvascular Surgery. Charlottesville. US
  • Hamdi, Osama; University of Virginia. Department of Otolaryngology, Head and Neck Surgery. Division of Head and Neck Oncologic and Microvascular Surgery. Charlottesville. US
  • Donaldson, Lane; University of Virginia. Department of Otolaryngology, Head and Neck Surgery. Division of Head and Neck Oncologic and Microvascular Surgery. Charlottesville. US
  • Zhan, Kevin; University of Virginia. Department of Otolaryngology, Head and Neck Surgery. Division of Head and Neck Oncologic and Microvascular Surgery. Charlottesville. US
  • Crandley, Edwin F.; University of Virginia. Department of Radiation Oncology. Charlottesville. US
  • Wilson, David D.; University of Virginia. Department of Radiation Oncology. Charlottesville. US
  • Sim, Austin J.; University of Virginia. Department of Radiation Oncology. Charlottesville. US
  • Read, Paul W.; University of Virginia. Department of Radiation Oncology. Charlottesville. US
  • Garneau, Jonathan C.; University of Virginia. Department of Otolaryngology, Head and Neck Surgery. Division of Head and Neck Oncologic and Microvascular Surgery. Charlottesville. US
  • Fedder, Katherine L.; University of Virginia. Department of Otolaryngology, Head and Neck Surgery. Division of Head and Neck Oncologic and Microvascular Surgery. Charlottesville. US
  • Shonka Jr., David C.; University of Virginia. Department of Otolaryngology, Head and Neck Surgery. Division of Head and Neck Oncologic and Microvascular Surgery. Charlottesville. US
  • Jameson, Mark J.; University of Virginia. Department of Otolaryngology, Head and Neck Surgery. Division of Head and Neck Oncologic and Microvascular Surgery. Charlottesville. US
Int. arch. otorhinolaryngol. (Impr.) ; 28(1): 42-49, 2024. tab, graf
Article em En | LILACS-Express | LILACS | ID: biblio-1558009
Biblioteca responsável: BR1.1
ABSTRACT
Abstract Introduction Human papillomavirus-related (HPV +) oropharyngeal squamous cell carcinoma (OPSCC) is increasing in incidence and presents diagnostic challenges given its unique clinical presentation. Objective The purpose of the present study is to characterize the impact of the unique clinical presentation of HPV-related OPSCC on delays in diagnosis. Methods Retrospective review of presenting symptoms and clinical characteristics of 284 patients with OPSCC treated from 2002-2014. Delay in diagnosis was defined as the presence of any of the following multiple non-diagnostic fine needle aspirate (FNA) biopsies; two or more courses of antibiotic therapy; surgery with incorrect preoperative diagnosis; evaluation by an otolaryngologist without further workup; or surgery without definitive postoperative diagnosis. Results p16+ tumors demonstrated a distinct clinical presentation that more commonly involved a neck mass (85.1% versus 57.3% of p16-; p < 0.001) and less frequently included odynophagia (24.6% versus 51.7% of p16-; p < 0.001). Patients who experienced diagnostic delay were more likely to have p16+ tumors (77.7% delayed versus 62.8% not delayed; p = 0.006). p16+ primary tumors were more likely to be undetectable by physical examination of the head and neck including flexible laryngoscopy (19.0% versus 6.7% of p16-; p = 0.007) and more frequently associated with nondiagnostic FNA biopsies of a cervical nodal mass (11.8% versus 3.4% of p16-, p = 0.03). Conclusions Compared with non-HPV related OPSCC, the unique clinical presentation and characteristics of HPV+ OPSCC are associated with an increased incidence of diagnostic delay. Targeted education of appropriate care providers may improve time to diagnosis and treatment.
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Idioma: En Revista: Int. arch. otorhinolaryngol. (Impr.) Assunto da revista: OTORRINOLARINGOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Idioma: En Revista: Int. arch. otorhinolaryngol. (Impr.) Assunto da revista: OTORRINOLARINGOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Brasil