Predictors of oropharyngeal cancer survival in Europe

• Published in: Oral oncology 2018-06, Vol.81, p.89-94
• Main Authors: Anantharaman, D., Billot, A., Waterboer, T., Gheit, T., Abedi-Ardekani, B., Lagiou, P., Lagiou, A., Ahrens, W., Holcátová, I., Merletti, F., Kjaerheim, K., Polesel, J., Simonato, L., Alemany, L., Mena Cervigon, M., Macfarlane, T.V., Znaor, A., Thomson, P.J., Robinson, M., Canova, C., Conway, D.I., Wright, S., Healy, C.M., Toner, M.E., Pawlita, M., Tommasino, M., Brennan, P.
• Format: Article
• Language: English
• Subjects: Alphapapillomavirus - isolation & purification; Body Mass Index; Female; Gender; Head and neck cancer; HPV16; Humans; Life Sciences; Male; Middle Aged; Neoplasm Recurrence, Local; Oropharyngeal Neoplasms - pathology; Oropharyngeal Neoplasms - virology; Oropharynx cancer; Retrospective Studies; Risk Factors; Santé publique et épidémiologie; Smoking; Survival; Survival Analysis; Tobacco; Tumor Virus Infections - pathology; Tumor Virus Infections - virology
• ISSN: 1368-8375; 1879-0593
• DOI: 10.1016/j.oraloncology.2018.04.016

•The role of patient-related factors in oropharyngeal cancer survival is examined.•Findings based on a large multi-centric retrospective study with 321 cases.•Being female and low BMI at diagnosis were significantly associated with oropharyngeal cancer outcomes. HPV16-positive oropharyngeal cancer (OPC) patients experience better outcomes compared to HPV16-negative patients. Currently, strategies for treatment de-escalation are based on HPV status, smoking history and disease stage. However, the appropriate cut-point for smoking and the role of other non-clinical factors in OPC survival remains uncertain. We examined factors associated with OPC outcome in 321 patients recruited in a large European multi-center study. Seropositivity for HPV16 E6 was used as a marker of HPV16 positive cancer. Hazard ratios (HR) and confidence intervals (CI) were estimated using Cox proportional models adjusted for potential confounders. Overall 5-year survival following OPC diagnosis was 50%. HPV16-positive OPC cases were at significantly lower risk of death (aHR = 0.51, 95% CI: 0.32–0.80). A significant effect on OPC survival was apparent for female sex (aHR 0.50: 95% CI: 0.29–0.85) and being underweight at diagnosis (aHR: 2.41, 95% CI: 1.38–4.21). A 10 pack year smoking history was not associated with overall survival. Higher stage at diagnosis appeared as the only factor significantly associated with OPC recurrence (aHR: 4.88, 95% CI: 2.12–11.21). This study confirms that HPV16 status is an independent prognostic factor for OPC survival while female sex lowers risk of death and being underweight at diagnosis increases the risk of death. Smoking was not an independent predictor of OPC survival.