Dorian Culié1, Renaud Garrel2, Julien Viotti3, Renaud Schiappa3, Emmanuel Chamorey3, Nicolas Fakhry4, Benjamin Lallemant5, Sébastien Vergez6, Agnès Dupret-Bories6, Olivier Dassonville1, Gilles Poissonnet1, José Santini1, Frédéric Peyrade7, Karen Benezery8, Anne Sudaka9, Florence Jourdan-Soulier10, Françoise Chapel10, Bruno Guelfucci11, Alexandre Bozec12. 1. Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France. 2. Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Montpellier, France. 3. Department of Statistics, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France. 4. Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Marseille, France. 5. Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, France. 6. Institut Universitaire du Cancer de Toulouse, Oncopole, Toulouse, France. 7. Department of Medical Oncology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France. 8. Department of Radiotherapy, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France. 9. Department of Pathology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France. 10. Department of Pathology, Sainte Musse Hospital, Toulon, France. 11. Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France. 12. Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France. Electronic address: alexandre.bozec@nice.unicancer.fr.
Abstract
OBJECTIVES: To analyze the impact of tumor p16 status and other clinical factors on the therapeutic decision-making process in patients with oropharyngeal squamous cell carcinoma (OPSCC). METHODS: We conducted a multicenter retrospective study (GETTEC collaborative study group) enrolling all OPSCC patients with a determined p16-status considered eligible for surgery between 2009 and 2014. The impact of p16-status and other clinical factors on the therapeutic decision was evaluated in multivariate analysis. RESULTS: A total of 476 patients were enrolled in the study, including 244 cases (51%) of p16-positive OPSCC. Overall, 223 (47%) patients underwent primary surgery, and 184 (83%) of them received postoperative radiotherapy ± chemotherapy. More patients with p16-positive OPSCC tended to undergo non-surgical treatment than did patients with p16-negative OPSCC (p = 0.10). Multivariate analysis showed that 5 factors significantly influenced therapeutic management of the patients: T-stage ≥ 3 (towards a non-surgical strategy; p < 0.001), N-stage ≥ 2a (non-surgical strategy; p = 0.02), tumor involvement of the glosso-tonsillar sulcus (surgical strategy; p = 0.002), tumor extension to the oral cavity (surgical strategy; p < 0.009) and the center of care (p < 0.001). The rate of patients directed towards a surgical strategy varied between 9% and 74% depending on the center. CONCLUSION: There was a non-significant trend to recommend patients with p16-positive OPSCC for non-surgical treatment. Center of care, tumor stage and tumor anatomical subsite and extensions were the main determinants of the treatment choice.
OBJECTIVES: To analyze the impact of tumorp16 status and other clinical factors on the therapeutic decision-making process in patients with oropharyngeal squamous cell carcinoma (OPSCC). METHODS: We conducted a multicenter retrospective study (GETTEC collaborative study group) enrolling all OPSCC patients with a determined p16-status considered eligible for surgery between 2009 and 2014. The impact of p16-status and other clinical factors on the therapeutic decision was evaluated in multivariate analysis. RESULTS: A total of 476 patients were enrolled in the study, including 244 cases (51%) of p16-positive OPSCC. Overall, 223 (47%) patients underwent primary surgery, and 184 (83%) of them received postoperative radiotherapy ± chemotherapy. More patients with p16-positive OPSCC tended to undergo non-surgical treatment than did patients with p16-negative OPSCC (p = 0.10). Multivariate analysis showed that 5 factors significantly influenced therapeutic management of the patients: T-stage ≥ 3 (towards a non-surgical strategy; p < 0.001), N-stage ≥ 2a (non-surgical strategy; p = 0.02), tumor involvement of the glosso-tonsillar sulcus (surgical strategy; p = 0.002), tumor extension to the oral cavity (surgical strategy; p < 0.009) and the center of care (p < 0.001). The rate of patients directed towards a surgical strategy varied between 9% and 74% depending on the center. CONCLUSION: There was a non-significant trend to recommend patients with p16-positive OPSCC for non-surgical treatment. Center of care, tumor stage and tumor anatomical subsite and extensions were the main determinants of the treatment choice.
Authors: Anthony C Nichols; Pencilla Lang; Eitan Prisman; Eric Berthelet; Eric Tran; Sarah Hamilton; Jonn Wu; Kevin Fung; John R de Almeida; Andrew Bayley; David P Goldstein; Antoine Eskander; Zain Husain; Houda Bahig; Apostolos Christopoulous; Michael Hier; Khalil Sultanem; Keith Richardson; Alex Mlynarek; Suren Krishnan; Hien Le; John Yoo; S Danielle MacNeil; Adrian Mendez; Eric Winquist; Nancy Read; Varagur Venkatesan; Sara Kuruvilla; Andrew Warner; Sylvia Mitchell; Martin Corsten; Murali Rajaraman; Stephanie Johnson-Obaseki; Libni Eapen; Michael Odell; Shamir Chandarana; Robyn Banerjee; Joseph Dort; T Wayne Matthews; Robert Hart; Paul Kerr; Samuel Dowthwaite; Michael Gupta; Han Zhang; Jim Wright; Christina Parker; Bret Wehrli; Keith Kwan; Julie Theurer; David A Palma Journal: BMC Cancer Date: 2020-02-14 Impact factor: 4.430