Elaine O Bigelow1, Jonathan Harris2, Carole Fakhry1, Maura L Gillison3, Phuc Felix Nguyen-Tân4, David I Rosenthal3, Steven J Frank3, Suresh G Nair5, Houda Bahig4, John A Ridge6, Jimmy Caudell7, Craig Donaldson8, Bradley T Clifford9, George Shenouda10, Michael J Birrer11, Yuhchyau Chen12, Quynh-Thu Le13. 1. Department of Otolaryngology - Head & Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA. 2. NRG Oncology Statistics and Data Management Center, American College of Radiology, Philadelphia, Pennsylvania, USA. 3. The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA. 4. Department of Radiation Oncology, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada. 5. Department of Hematology and Oncology, Lehigh Valley Hospital, Allentown, Pennsylvania, USA. 6. Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA. 7. H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA. 8. Intermountain Medical Center, St. George, Utah, USA. 9. Department of Oncology, Summa Health System - Akron Campus, Akron, Ohio, USA. 10. Department of Radiation Oncology, The Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, Canada. 11. Department of Medical Oncology, University of Alabama at Birmingham Cancer Center, Birmingham, Alabama, USA. 12. Department of Radiation Oncology, University of Rochester, Rochester, New York, USA. 13. Department of Radiation Oncology, Stanford University, Stanford, California, USA.
Abstract
BACKGROUND: No risk-stratification strategies exist for patients with recurrent oropharyngeal cancer (OPC). METHODS: Retrospective analysis using data from prospective NRG Oncology clinical trials RTOG 0129 and 0522. Eligibility criteria included known p16 status and smoking history, and locoregional/distant recurrence. Overall survival (OS) was measured from date of recurrence. Recursive partitioning analysis was performed to produce mutually exclusive risk groups. RESULTS: Hundred and fifty-four patients were included with median follow-up after recurrence of 3.9 years (range 0.04-9.0). The most important factors influencing survival were p16 status and type of recurrence, followed by surgical salvage and smoking history (≤20 vs. >20 pack-years). Three significantly different risk groups were identified. Patients in the low-, intermediate-, and high-risk groups had 2-year OS after recurrence of 81.1% (95%CI 68.5-93.7), 50.2% (95%CI 36.0-64.5), and 20.8% (95%CI 10.5-31.1), respectively. CONCLUSION: Patient and tumor characteristics may be used to stratify patients into risk groups at the time of OPC recurrence.
BACKGROUND: No risk-stratification strategies exist for patients with recurrent oropharyngeal cancer (OPC). METHODS: Retrospective analysis using data from prospective NRG Oncology clinical trials RTOG 0129 and 0522. Eligibility criteria included known p16 status and smoking history, and locoregional/distant recurrence. Overall survival (OS) was measured from date of recurrence. Recursive partitioning analysis was performed to produce mutually exclusive risk groups. RESULTS: Hundred and fifty-four patients were included with median follow-up after recurrence of 3.9 years (range 0.04-9.0). The most important factors influencing survival were p16 status and type of recurrence, followed by surgical salvage and smoking history (≤20 vs. >20 pack-years). Three significantly different risk groups were identified. Patients in the low-, intermediate-, and high-risk groups had 2-year OS after recurrence of 81.1% (95%CI 68.5-93.7), 50.2% (95%CI 36.0-64.5), and 20.8% (95%CI 10.5-31.1), respectively. CONCLUSION: Patient and tumor characteristics may be used to stratify patients into risk groups at the time of OPC recurrence.
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