Tumor stage, human papillomavirus and smoking status affect the survival of patients with oropharyngeal cancer: an Italian validation study
Open Access
- 24 November 2011
- journal article
- research article
- Published by Elsevier BV in Annals of Oncology
- Vol. 23 (7), 1832-1837
- https://doi.org/10.1093/annonc/mdr544
Abstract
Tumor human papillomavirus (HPV) status strongly affects overall survival (OS) of oropharyngeal cancer (OPC) patients. Recently, three groups with different outcomes were identified based on HPV status, smoking history and tumor stage. Our objective was to validate this model using a single-institutional retrospective database. Patients (n = 120) diagnosed with OPC at our institution, treated with concomitant cisplatin plus radiotherapy (RT) (n = 64), induction chemotherapy followed by concomitant chemoradiation (n = 39) or RT alone (n = 17), were stratified in three groups with respect to the risk of death (low 26, intermediate 46 and high 49 patients) according to tumor p16 expression as surrogate of HPV status, pack-years of tobacco smoking and nodal/tumor stage. Group-stratified Kaplan–Meier OS curves were estimated and compared using the log-rank test. The 2-year OS estimates were 100%, 86% and 70%, respectively. The difference between the survival curves was statistically significant (P = 0.009). The Harrell's concordance index was 0.70. The calibration plot showed a good concordance between our results and those observed in the original study. This study validates the risk grouping previously identified. Risk-driven clinical decision making and trial designs will help in better defining the most appropriate treatment in OPC patients.Keywords
This publication has 23 references indexed in Scilit:
- Integrating Epidermal Growth Factor Receptor Assay With Clinical Parameters Improves Risk Classification for Relapse and Survival in Head-and-Neck Squamous Cell CarcinomaInternational Journal of Radiation Oncology*Biology*Physics, 2011
- Prognostic significance of p16 in locally advanced squamous cell carcinoma of the head and neck treated with concurrent cisplatin and radiotherapyHead & Neck, 2011
- Prognostic Significance of p16INK4A and Human Papillomavirus in Patients With Oropharyngeal Cancer Treated on TROG 02.02 Phase III TrialJournal of Clinical Oncology, 2010
- Human Papillomavirus and Survival of Patients with Oropharyngeal CancerThe New England Journal of Medicine, 2010
- p16 expression in oropharyngeal cancer: its impact on staging and prognosis compared with the conventional clinical staging parametersAnnals Of Oncology, 2010
- EGFR, p16, HPV Titer, Bcl-xL and p53, Sex, and Smoking As Indicators of Response to Therapy and Survival in Oropharyngeal CancerJournal of Clinical Oncology, 2008
- Survival of squamous cell carcinoma of the head and neck in relation to human papillomavirus infection: Review and meta‐analysisInternational Journal of Cancer, 2007
- Papillomaviruses and cancer: from basic studies to clinical applicationNature Reviews Cancer, 2002
- Human Papillomavirus Infection as a Risk Factor for Squamous-Cell Carcinoma of the Head and NeckThe New England Journal of Medicine, 2001
- A Class of $K$-Sample Tests for Comparing the Cumulative Incidence of a Competing RiskThe Annals of Statistics, 1988