Staging and treatment of oropharyngeal cancer in the human papillomavirus era

• DOI: 10.1002/hed.23697
• Publication Date: 2014-04-03T08:22:41Z
• Authors: Matthew J. Ward; Toby Mellows; Scott Harris; Andrew Webb; Nimesh N. Patel; Hugh J. Cox; Kim Piper; Christian H. Otte...; Gareth J. Thomas; Emma V. King
• Keywords: Adult; Male; Squamous Cell Carcinoma of Head and Neck; Papillomavirus Infections; Kaplan-Meier Estimate; Middle Aged; Prognosis; 3. Good health; Oropharyngeal Neoplasms; 03 medical and health sciences; 0302 clinical medicine; Head and Neck Neoplasms; Carcinoma, Squamous Cell; Humans; Female; Papillomaviridae; Aged; Neoplasm Staging; Retrospective Studies

Oropharyngeal squamous cell carcinoma (SCC) is staged using the TNM system. Human papillomavirus (HPV)-positive tumors have improved prognosis, despite presenting at advanced stage. Optimal treatment and stratification of HPV-positive patients are not clearly defined.We retrospectively analyzed 266 with oropharyngeal SCC for mortality feeding tube dependency related to stage, HPV status, treatment.TNM staging was prognostic in HPV-negative (stage III/IV hazard ratio [HR], 2.00; p = .05; N(+) HR, 2.19; .02). Only T classification (T3/T4 HR 3.31; .006). showed survival regardless treatment. Patients receiving chemotherapy had a significantly increased risk (odds [OR], 1.72; .03).These data suggest that current system has little value SCC. show independent The addition increases could potentially be avoided T1/T2 without compromising survival.