D Anantharaman1, A Billot2, T Waterboer3, T Gheit2, B Abedi-Ardekani2, P Lagiou4, A Lagiou5, W Ahrens6, I Holcátová7, F Merletti8, K Kjaerheim9, J Polesel10, L Simonato11, L Alemany12, M Mena Cervigon12, T V Macfarlane13, A Znaor2, P J Thomson14, M Robinson15, C Canova16, D I Conway17, S Wright18, C M Healy19, M E Toner19, M Pawlita3, M Tommasino2, P Brennan20. 1. International Agency for Research on Cancer, Lyon, France; Cancer Research Program, Rajiv Gandhi Center for Biotechnology, Thiruvananthapuram, India. 2. International Agency for Research on Cancer, Lyon, France. 3. Division of Molecular Diagnostics of Oncogenic Infections, German Cancer Research Center (DKFZ), Heidelberg, Germany. 4. Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. 5. Department of Public Health and Community Health, School of Health Professions, Athens Technological Educational Institute, Athens, Greece. 6. BIPS - Institute for Epidemiology and Prevention Research, Bremen, Germany; Institute for Statistics, University Bremen, Bremen, Germany. 7. Institute of Hygiene and Epidemiology, Charles University of Prague, 1st Faculty of Medicine, Prague, Czech Republic. 8. Unit of Cancer Epidemiology, CeRMS and University of Turin, Turin, Italy. 9. Cancer Registry of Norway, Oslo, Norway. 10. Unit of Epidemiology and Biostatistics, National Cancer Institute, IRCCS, Aviano, Italy. 11. Department of Environmental Medicine and Public Health, University of Padova, Padova, Italy. 12. Institut Català d'Oncologia, IDIBELL, CIBERESP, L'Hospitalet de Llobregat, Spain. 13. Epidemiology Group, University of Aberdeen, Aberdeen, UK; Ninewells Hospital and Medical School, University of Dundee, Dundee, UK. 14. School of Dentistry, The University of Queensland, Herston, Australia. 15. Center for Oral Health Research, Newcastle University, Newcastle-upon-Tyne, UK. 16. Respiratory Epidemiology and Public Health, National Heart and Lung Institute, Imperial College, London, UK. 17. Dental School, University of Glasgow, Glasgow, UK; Information Services Division (ISD), NHS National Services Scotland, Edinburgh, UK. 18. Department of Pathology, Queen Elizabeth University Hospital, Glasgow, UK. 19. Trinity College School of Dental Science, Dublin, Ireland. 20. International Agency for Research on Cancer, Lyon, France. Electronic address: gep@iarc.fr.
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.
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.
Authors: Cyril Bouland; Didier Dequanter; Jérôme R Lechien; Charlotte Hanssens; Nicolas De Saint Aubain; Antoine Digonnet; Rokneddine Javadian; Antoine Yanni; Alexandra Rodriguez; Isabelle Loeb; Fabrice Journe; Sven Saussez Journal: Int J Otolaryngol Date: 2021-09-07
Authors: G Feliciani; F Fioroni; E Grassi; M Bertolini; A Rosca; G Timon; M Galaverni; C Iotti; A Versari; M Iori; P Ciammella Journal: Contrast Media Mol Imaging Date: 2018-09-27 Impact factor: 3.161