Prognostic significance of HPV status in postoperative squamous-cell carcinoma of the head and neck
| Autor: | Rebecca Redman, K. Potts, Cesar A. Perez, M.H. Bertke, Matthew K. Forsthoefel, Jeffrey M. Bumpous, Liz D Cash, Craig L. Silverman, Neal Dunlap, Joseph N Shaughnessy |
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| Rok vydání: | 2016 |
| Předmět: |
Oncology
medicine.medical_specialty business.industry Head and neck cancer Perineural invasion Hematology Disease medicine.disease Lymphovascular 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure 030220 oncology & carcinogenesis Internal medicine Cohort medicine Carcinoma 030212 general & internal medicine business Lymph node Chemoradiotherapy |
| Zdroj: | The Journal of Community and Supportive Oncology. 14:215-220 |
| ISSN: | 2330-7749 |
| Popis: | BACKGROUND There are limited data on the prognostic significance of human papillomavirus (HPV) status in relation to traditional risk factors for head and neck squamous-cell carcinoma (HNSCC) in the postoperative setting. OBJECTIVE To clarify the impact of HPV status on the risk for HNSCC in the postoperative setting. METHODS We retrospectively evaluated an institutional cohort of 128 patients with HNSCC patients who had been treated with definitive surgery with or without adjuvant radiotherapy or chemoradiotherapy. Patient, disease, and treatment factors were analyzed as potential prognostic indicators. RESULTS Lymph node extracapsular extension (ECE), perineural invasion (PNI), and lymphovascular space invasion (LVSI) positivity predicted poorer locoregional control (LRC), disease-free survival (DFS), and overall survival (OS). Positive margins related to poorer DFS and OS. HPV status alone did not predict LRC, DFS, or OS. Compared with patients who were HPV-positive and ECE-negative, both HPV-positive and HPV-negative patients with ECE experienced significantly poorer OS (78.6%, 60%, and 43.7%, respectively; 𝑃 = .010 and 𝑃 = .018, respectively). LIMITATIONS Retrospective, single-institution study; small patient cohort; short follow-up time. CONCLUSION The influence of HPV in postoperative HNSCC seems limited compared with traditional risk factors such as ECE, LVSI, and PNI. De-escalation of postoperative treatment based on HPV status alone should be approached with caution. |
| Databáze: | OpenAIRE |
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