Smoking, age, nodal disease, T stage, p16 status, and risk of distant metastases in patients with squamous cell cancer of the oropharynx
- 11 December 2018
- Vol. 125 (5), 704-711
- https://doi.org/10.1002/cncr.31820
Abstract
Background With an expectation of excellent locoregional control, ongoing efforts to de‐intensify therapy for patients with human papillomavirus–associated squamous cell oropharyngeal cancer necessitate a better understanding of the metastatic risk for patients with this disease. The objective of this study was to determine what factors affect the risk of metastases in patients with squamous cell cancers of the oropharynx. Methods Under a shared use agreement, 547 patients from Radiation Therapy Oncology Group 0129 and 0522 with nonmetastatic oropharyngeal squamous cell cancers who had a known p16 status and smoking status were analyzed to assess the association of clinical features with the development of distant metastases. The analyzed factors included the p16 status, sex, T stage, N stage, age, and smoking history. Results A multivariate analysis of 547 patients with a median follow‐up of 4.8 years revealed that an age ≥ 50 years (hazard ratio [HR], 3.28; P = .003), smoking for more than 0 pack‐years (HR, 3.09; P < .001), N3 disease (HR, 2.64; P < .001), T4 disease (HR, 1.63; P = .030), and a negative p16 status (HR, 1.60; P = .044) were all factors associated with an increased risk of distant disease. Conclusions Age, smoking, N3 disease, T4 disease, and a negative p16 status were associated with the development of distant metastases in patients with squamous cell cancers of the oropharynx treated definitively with concurrent chemoradiation.Keywords
Funding Information
- Emory University
- National Institutes of Health
- National Cancer Institute (P30CA138292)
This publication has 12 references indexed in Scilit:
- Risk of Solid Cancer After Treatment of Testicular Germ Cell Cancer in the Platinum EraJournal of Clinical Oncology, 2018
- The immune system in cancer metastasis: friend or foe?Journal for ImmunoTherapy of Cancer, 2017
- Adverse effect of smoking on prognosis in human papillomavirus–associated oropharyngeal carcinomaHead & Neck, 2016
- Randomized Phase III Trial of Concurrent Accelerated Radiation Plus Cisplatin With or Without Cetuximab for Stage III to IV Head and Neck Carcinoma: RTOG 0522Journal of Clinical Oncology, 2014
- Long-Term Results of RTOG 91-11: A Comparison of Three Nonsurgical Treatment Strategies to Preserve the Larynx in Patients With Locally Advanced Larynx CancerJournal of Clinical Oncology, 2013
- Deintensification Candidate Subgroups in Human Papillomavirus–Related Oropharyngeal Cancer According to Minimal Risk of Distant MetastasisJournal of Clinical Oncology, 2013
- Long-term Follow-up of the RTOG 9501/Intergroup Phase III Trial: Postoperative Concurrent Radiation Therapy and Chemotherapy in High-Risk Squamous Cell Carcinoma of the Head and NeckInternational Journal of Radiation Oncology*Biology*Physics, 2012
- HPV Positive Squamous Cell Carcinoma of the Oropharynx. Are we Observing an Unusual Pattern of Metastases?Head and Neck Pathology, 2012
- Human Papillomavirus and Survival of Patients with Oropharyngeal CancerThe New England Journal of Medicine, 2010
- Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): An update on 93 randomised trials and 17,346 patientsRadiotherapy and Oncology, 2009