Locoregional and distant recurrence for HPV-associated oropharyngeal cancer using AJCC 8 staging

•HPV-associated oropharyngeal cancer has unique patterns of recurrence.•Risk of locoregional recurrence is stratified by smoking, T/N category, and stage.•Risk of distant recurrence is only stratified by smoking and not by stage. The objective of this study is to evaluate locoregional and distant fa...

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Published in:Oral oncology 2020-12, Vol.111, p.105030-105030, Article 105030
Main Authors: Contrera, Kevin J., Smile, Timothy D., Mahomva, Chengetai, Wei, Wei, Adelstein, David J., Broughman, James R., Burkey, Brian B, Geiger, Jessica L., Joshi, Nikhil P., Ku, Jamie A., Lamarre, Eric D., Lorenz, Robert R., Prendes, Brandon L., Scharpf, Joseph, Schwartzman, Larisa M., Woody, Neil M., Xiong, David, Koyfman, Shlomo A.
Format: Article
Language:English
Subjects:
American Joint Committee on Cancer
Chemotherapy
Head and neck cancer
Human papillomavirus-associated
Metastasis
Oropharyngeal
Radiation
Recurrence
Squamous cell carcinoma
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creator Contrera, Kevin J.
Smile, Timothy D.
Mahomva, Chengetai
Wei, Wei
Adelstein, David J.
Broughman, James R.
Burkey, Brian B
Geiger, Jessica L.
Joshi, Nikhil P.
Ku, Jamie A.
Lamarre, Eric D.
Lorenz, Robert R.
Prendes, Brandon L.
Scharpf, Joseph
Schwartzman, Larisa M.
Woody, Neil M.
Xiong, David
Koyfman, Shlomo A.
description •HPV-associated oropharyngeal cancer has unique patterns of recurrence.•Risk of locoregional recurrence is stratified by smoking, T/N category, and stage.•Risk of distant recurrence is only stratified by smoking and not by stage. The objective of this study is to evaluate locoregional and distant failure for human papillomavirus-associated (HPV+) oropharyngeal squamous cell carcinoma (OPSCC) using American Joint Committee on Cancer eighth edition (AJCC 8) staging. Retrospective cohort study of 457 patients with HPV + OPSCC, treated with platinum-based chemoradiation from 2002 to 2018, followed for a median of 4.3 years. Time to locoregional failure (TTLRF) and distant failure (TTDF) were estimated by Kaplan-Meier method. Log-rank, recursive partitioning analysis (RPA), and multivariable Cox proportional hazards were used to evaluate associated factors and stratify risk. Rates of five-year locoregional control (LRC) and distant control (DC) were 92% (95% CI, 90–95%) and 89% (95% CI, 85–92%), respectively. Smoking, T4, N3, and stage III were associated with significantly worse TTLRF. RPA identified three distinct locoregional failure groups: cT1-3 and 
doi_str_mv 10.1016/j.oraloncology.2020.105030
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The objective of this study is to evaluate locoregional and distant failure for human papillomavirus-associated (HPV+) oropharyngeal squamous cell carcinoma (OPSCC) using American Joint Committee on Cancer eighth edition (AJCC 8) staging. Retrospective cohort study of 457 patients with HPV + OPSCC, treated with platinum-based chemoradiation from 2002 to 2018, followed for a median of 4.3 years. Time to locoregional failure (TTLRF) and distant failure (TTDF) were estimated by Kaplan-Meier method. Log-rank, recursive partitioning analysis (RPA), and multivariable Cox proportional hazards were used to evaluate associated factors and stratify risk. Rates of five-year locoregional control (LRC) and distant control (DC) were 92% (95% CI, 90–95%) and 89% (95% CI, 85–92%), respectively. Smoking, T4, N3, and stage III were associated with significantly worse TTLRF. RPA identified three distinct locoregional failure groups: cT1-3 and &lt;19 pack-years vs. cT1-3 with ≥19 pack-years vs. cT4 (five-year LRC: 97% vs. 90% vs. 82%, P &lt; .0001). The only factor associated with significantly worse TTDF was smoking status, while stage was not correlated. RPA identified two prognostic groups: former or never smokers vs. current smokers (five-year DC: 92% vs. 77%, P = .0003). In the largest evaluation of HPV + OPSCC after platinum-based chemoradiation using AJCC 8, risk for locoregional recurrence was stratified by smoking, T category, N category, and overall stage. Risk of distant recurrence was only stratified by smoking status and not related to stage. 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The objective of this study is to evaluate locoregional and distant failure for human papillomavirus-associated (HPV+) oropharyngeal squamous cell carcinoma (OPSCC) using American Joint Committee on Cancer eighth edition (AJCC 8) staging. Retrospective cohort study of 457 patients with HPV + OPSCC, treated with platinum-based chemoradiation from 2002 to 2018, followed for a median of 4.3 years. Time to locoregional failure (TTLRF) and distant failure (TTDF) were estimated by Kaplan-Meier method. Log-rank, recursive partitioning analysis (RPA), and multivariable Cox proportional hazards were used to evaluate associated factors and stratify risk. Rates of five-year locoregional control (LRC) and distant control (DC) were 92% (95% CI, 90–95%) and 89% (95% CI, 85–92%), respectively. Smoking, T4, N3, and stage III were associated with significantly worse TTLRF. RPA identified three distinct locoregional failure groups: cT1-3 and &lt;19 pack-years vs. cT1-3 with ≥19 pack-years vs. cT4 (five-year LRC: 97% vs. 90% vs. 82%, P &lt; .0001). The only factor associated with significantly worse TTDF was smoking status, while stage was not correlated. RPA identified two prognostic groups: former or never smokers vs. current smokers (five-year DC: 92% vs. 77%, P = .0003). In the largest evaluation of HPV + OPSCC after platinum-based chemoradiation using AJCC 8, risk for locoregional recurrence was stratified by smoking, T category, N category, and overall stage. Risk of distant recurrence was only stratified by smoking status and not related to stage. 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subjects American Joint Committee on Cancer
Chemotherapy
Head and neck cancer
Human papillomavirus-associated
Metastasis
Oropharyngeal
Radiation
Recurrence
Squamous cell carcinoma
title Locoregional and distant recurrence for HPV-associated oropharyngeal cancer using AJCC 8 staging
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