Refining prognostic stratification of human papillomavirus-related oropharyngeal squamous cell carcinoma: different prognosis between T1 and T2.
- Author:
Sumin LEE
1
;
Sang wook LEE
;
Sunmin PARK
;
Sang Min YOON
;
Jin hong PARK
;
Si Yeol SONG
;
Seung Do AHN
;
Jong Hoon KIM
;
Eun Kyung CHOI
;
Su Ssan KIM
;
Jinhong JUNG
;
Young Seok KIM
Author Information
- Publication Type:Original Article
- Keywords: Human papillomavirus; Oropharyngeal neoplasms; Squamous cell carcinoma; Neoplasm staging
- MeSH: Carcinoma, Squamous Cell*; Classification; DNA; Epithelial Cells*; Humans*; Joints; Medical Records; Neoplasm Staging; Oropharyngeal Neoplasms; Palatine Tonsil; Polymerase Chain Reaction; Prognosis*; Retrospective Studies; Survival Rate
- From:Radiation Oncology Journal 2017;35(3):233-240
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: To validate the 8th edition of the American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) TNM staging system for human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) and investigate whether a modified classification better reflects the prognosis. MATERIALS AND METHODS: Medical records of patients diagnosed with non-metastatic HPV-related OPSCC between 2010 and 2016 at a single institution were retrospectively reviewed. HPV status was determined by immunohistochemical analysis of p16 and/or HPV DNA polymerase chain reaction (PCR). We reclassified TNM stage T0-1 and N0-1 as group A, T2-3 or N2 as B, and T4 or N3 as C. Survival analysis according to 8th AJCC/UICC TNM staging and the modified classification was performed. RESULTS: Of 383 OPSCC patients, 211 were positive for HPV DNA PCR or p16. After exclusion, 184 patients were included in this analysis. Median age was 56 years (range, 31 to 81 years). Most primary tumors were in the palatine tonsil (148 tumors, 80%). The eighth AJCC/UICC TNM classification could not differentiate between stage I and II (p = 0.470) or II and III (p = 0.209). Applying modified grouping, the 3-year overall survival rate of group A was significantly higher than that of group B and C (98% vs. 91%, p = 0.039 and 98% vs. 78%, p < 0.001, respectively). Differentiation between group B and C was marginally significant (p = 0.053). CONCLUSION: The 8th AJCC/UICC TNM staging system did not clearly distinguish the prognosis of stage II from that of other stages. Including the T2N0-1 group in stage II may improve prognostic stratification.
