Juliette Thariat1, Xavier Dufour2, Charles Hurel2, Florent Carsuzaa3, Julia Salleron4, Philippe Gorphe5, Christian Righini6, Maximilien Rogé7, Erwan de Mones8, Sylvain Morinière9, Sébastien Vergez10. 1. Radiotherapy, Centre François Baclesse/ARCHADE, Caen, France. 2. Head and Neck Surgery, Service ORL, chirurgie cervico-maxillo-faciale et audiophonologie, Centre Hospitalier Universitaire de Poitiers, 2 rue de la Milétrie, 86021, Poitiers Cedex, France. 3. Head and Neck Surgery, Service ORL, chirurgie cervico-maxillo-faciale et audiophonologie, Centre Hospitalier Universitaire de Poitiers, 2 rue de la Milétrie, 86021, Poitiers Cedex, France. florent.carsuzaa@gmail.com. 4. Cellule Data Biostatistique, Institut de Cancérologie de Lorraine, Université de Lorraine, 54519, Vandœuvre-lès-Nancy, France. 5. Department of Head and Neck Oncology, Gustave Roussy, University Paris-Saclay, Villejuif, France. 6. Head and Neck Surgery, University Hospital of Grenoble, La Tronche, France. 7. Radiation Oncology, Centre Henri Becquerel, Rouen, France. 8. Head and Neck Surgery, University Hospital of Tours, Tours, France. 9. Head and Neck Surgery, University Hospital of Bordeaux, Bordeaux cedex, France. 10. Institut Universitaire du Cancer de Toulouse Oncopole-CHU de Toulouse, Toulouse, France.
Abstract
PURPOSE: The purpose of our study was to investigate the impact of HPV status in oncologic outcomes in patients with T1-2 oropharyngeal SCC associated with bulky N3 nodes, and to determine progression prognosis factors aiming to define the best therapeutic strategies for these patients. METHODS: This multicenter retrospective study included patients with T1-2 oropharyngeal SCC with N3 nodes treated between 2010 and 2015 in 8 French comprehensive cancer centers. HPV status was determined with P16 hyperexpression in immunohistochemistry. HPV-positive patients were separated into 2 groups according to the associated smoking history (HPV + T +) or not (HPV + T-). We compared the oncological outcomes of patients according to HPV-status and smoking history. RESULTS: Of 67 patients with T1-2 N3 oropharyngeal SCC, 36 patients (53.7%) were HPV negative and 31 patients (46.3%) HPV positive. 2-year PFS was significantly better in HPV + T- group (p = 0.036). The risk of death or progression was significantly reduced in HPV + T- comparatively to HPV- (HR 0.25 95%CI [0.07; 0.89]). 2-year OS was significantly better in HPV + T- group than in the other two groups (p = 0.017). CONCLUSION: In patients with T1-2 oropharyngeal SCC associated with bulky N3 nodes, HPV positive patients without smoking history had better OS and PFS than HPV positive patients with smoking history and HPV negative patients. Thus, HPV status is a significant prognostic factor for survival but this benefit is altered when smoking history is associated. N3 HPV positive patients with smoking history have to be classified as high-risk.
PURPOSE: The purpose of our study was to investigate the impact of HPV status in oncologic outcomes in patients with T1-2 oropharyngeal SCC associated with bulky N3 nodes, and to determine progression prognosis factors aiming to define the best therapeutic strategies for these patients. METHODS: This multicenter retrospective study included patients with T1-2 oropharyngeal SCC with N3 nodes treated between 2010 and 2015 in 8 French comprehensive cancer centers. HPV status was determined with P16 hyperexpression in immunohistochemistry. HPV-positive patients were separated into 2 groups according to the associated smoking history (HPV + T +) or not (HPV + T-). We compared the oncological outcomes of patients according to HPV-status and smoking history. RESULTS: Of 67 patients with T1-2 N3 oropharyngeal SCC, 36 patients (53.7%) were HPV negative and 31 patients (46.3%) HPV positive. 2-year PFS was significantly better in HPV + T- group (p = 0.036). The risk of death or progression was significantly reduced in HPV + T- comparatively to HPV- (HR 0.25 95%CI [0.07; 0.89]). 2-year OS was significantly better in HPV + T- group than in the other two groups (p = 0.017). CONCLUSION: In patients with T1-2 oropharyngeal SCC associated with bulky N3 nodes, HPV positive patients without smoking history had better OS and PFS than HPV positive patients with smoking history and HPV negative patients. Thus, HPV status is a significant prognostic factor for survival but this benefit is altered when smoking history is associated. N3 HPV positive patients with smoking history have to be classified as high-risk.