Characteristics and long-term outcomes of head and neck squamous cell carcinoma after solid organ transplantation
| Autor: | Daniel J. Ma, Katharine A. Price, Ashish V. Chintakuntlawar, Joaquin J. Garcia, Samer Alsidawi, Gustavo Figueiredo Marcondes Westin, Scott H. Okuno |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Oncology Larynx Cancer Research medicine.medical_specialty medicine.medical_treatment Population 03 medical and health sciences 0302 clinical medicine Recurrence Internal medicine medicine Adjuvant therapy Humans 030212 general & internal medicine Progression-free survival education Aged Proportional Hazards Models Retrospective Studies education.field_of_study Squamous Cell Carcinoma of Head and Neck Proportional hazards model business.industry Head and neck cancer Immunosuppression Organ Transplantation Middle Aged medicine.disease Survival Analysis Head and neck squamous-cell carcinoma stomatognathic diseases Treatment Outcome medicine.anatomical_structure Head and Neck Neoplasms 030220 oncology & carcinogenesis Carcinoma Squamous Cell Female Oral Surgery business |
| Zdroj: | Oral Oncology. 72:104-109 |
| ISSN: | 1368-8375 |
| DOI: | 10.1016/j.oraloncology.2017.07.010 |
| Popis: | Introduction Immunosuppression after solid organ transplant prevents graft rejection, but leads to increased incidence of various malignancies including head and neck squamous cell carcinoma (HNSCC). Outcomes of patients with post-transplant HNSCC are unknown. Materials and methods We retrospectively identified patients who developed HNSCC after solid organ transplant between 1995 and 2010. Adults with pathology-proven HNSCC and adequate follow up were included. Median overall survival and progression free survival were analyzed using the Kaplan-Meier method. The prognostic effect of variables was studied with Cox proportional hazards models. Results Thirty-three patients met study inclusion criteria. The median time to diagnosis of HNSCC after transplant was 5.9 years. The primary site was oral cavity in 15 patients, oropharynx in 10, larynx in 3, hypopharynx in 2, parotid in 2 and unknown in 1 patient. Eighty-eight percent underwent upfront surgical resection. Of those, sixty-six percent received adjuvant therapy. Six percent of patients had definitive chemoradiation. Treatment was well tolerated and did not lead to graft rejection. The 5-year overall survival rate was 45% and 37% for localized and locally advanced disease respectively. Seventy-five percent of patients with oropharyngeal tumors were HPV-positive and they had better outcomes (5-year overall survival rate of 67%). In multivariate analysis, age ≥60 years was a negative predictor of survival (HR 2.7; 95% CI, 1.1–6.5; P = 0.03). Conclusions Patients with post-transplant HNSCC have relatively poor survival and high risk of locoregional and distant recurrence. HPV- positive oropharyngeal tumors continue to have better outcomes in this population. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect