An evolution in demographics, treatment, and outcomes of oropharyngeal cancer at a major cancer center
Open Access
- 26 June 2012
- Vol. 119 (1), 81-89
- https://doi.org/10.1002/cncr.27727
Abstract
BACKGROUND: In this retrospective review, the authors examined demographic/clinical characteristics and overall survival in patients with squamous cell carcinoma of the oropharynx at a tertiary cancer center, and they report the characteristics that influenced any observed survival trends over time. METHODS: The study included 3891 newly diagnosed, previously untreated patients who presented at the authors' institution between 1955 and 2004. RESULTS: Over time, patients presented at younger ages and were more likely to have base of tongue or tonsil tumors and to be never‐smokers or former smokers. Patients who were diagnosed between 1995 and 2004 were almost half as likely to die as those who were diagnosed before 1995 (hazard ratio, 0.6; 95% confidence interval, 0.6‐0.8). In both multivariable and recursive partitioning survival analyses, the TNM staging system predicted the survival of patients who received treatment before 1995 but did not predict the survival patients treated during the period from 1995 to 2004. CONCLUSIONS: Survival among patients with squamous cell carcinoma of the oropharynx improved substantially over the past 50 years. The main contributing factors were changes in clinical characteristics, in particular surrogates for positive human papillomavirus status. The current TNM staging system for squamous cell carcinoma of the oropharynx is inadequate. The incorporation of human papillomavirus status and perhaps smoking status into the TNM system is encouraged. Cancer 2013. © 2012 American Cancer Society.Keywords
This publication has 32 references indexed in Scilit:
- Survival and human papillomavirus in oropharynx cancer in TAX 324: a subset analysis from an international phase III trialAnnals of Oncology, 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
- Incidence of human papillomavirus (HPV) positive tonsillar carcinoma in Stockholm, Sweden: An epidemic of viral‐induced carcinoma?International Journal of Cancer, 2009
- Chemoselection As a Strategy for Organ Preservation in Advanced Oropharynx Cancer: Response and Survival Positively Associated With HPV16 Copy NumberJournal of Clinical Oncology, 2008
- Improved Survival of Patients With Human Papillomavirus-Positive Head and Neck Squamous Cell Carcinoma in a Prospective Clinical TrialJNCI Journal of the National Cancer Institute, 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
- Trends in incidence and prognosis for head and neck cancer in the United States: A site‐specific analysis of the SEER databaseInternational Journal of Cancer, 2005
- Human Papillomavirus Types in Head and Neck Squamous Cell Carcinomas Worldwide: A Systematic ReviewCancer Epidemiology, Biomarkers & Prevention, 2005
- Matched-Pair Analysis of Survival of Never Smokers and Ever Smokers With Squamous Cell Carcinoma of the Head and NeckJournal of Clinical Oncology, 2004