Predictors of oropharyngeal cancer survival in Europe

D. Anantharaman, A. Billot, T. Waterboer, T. Gheit, B. Abedi-Ardekani, P. Lagiou, A. Lagiou, W. Ahrens, I. Holcátová, F. Merletti, K. Kjaerheim, J. Polesel, L. Simonato, L. Alemany, M. Mena Cervigon, T. V. Macfarlane, A. Znaor, P. J. Thomson, M. Robinson, C. CanovaD. I. Conway, S. Wright, C. M. Healy, M. E. Toner, M. Pawlita, M. Tommasino, P. Brennan

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    Abstract

    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.

    Original languageEnglish
    Pages (from-to)89-94
    Number of pages6
    JournalOral Oncology
    Volume81
    Early online date2 May 2018
    DOIs
    Publication statusPublished - 1 Jun 2018

    Keywords

    • Body mass index
    • Gender
    • Head and neck cancer
    • HPV16
    • Oropharynx cancer
    • Survival
    • Tobacco

    ASJC Scopus subject areas

    • Oral Surgery
    • Oncology
    • Cancer Research

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