Locally advanced hypopharyngeal and laryngeal cancer: Influence of HPV status - PubMed (original) (raw)
Locally advanced hypopharyngeal and laryngeal cancer: Influence of HPV status
James E Bates et al. Radiother Oncol. 2019 Nov.
Abstract
Background: Larynx preservation with chemoradiotherapy (CRT) is used frequently in the treatment of locally advanced hypopharyngeal/laryngeal squamous cell carcinoma (LSCC). Multiple large retrospective analyses have shown that CRT is associated with worse overall survival (OS) compared to total laryngectomy (TL) in patients with T4a disease. Burgeoning evidence suggests HPV status may play a prognostic role in patients with LSCC. We aimed to determine if HPV status influences OS among patients with T4a LSCC, and, if so, if it may be useful in selecting patients for CRT.
Methods: Using the National Cancer Database (NCDB), we identified 810 patients with T4a N0-3 M0 squamous cell carcinoma of the larynx or hypopharynx with known HPV status who received either definitive CRT (to 66-81.6 Gy with any chemotherapy) or definitive TL (with the addition of 60-70 Gy of adjuvant RT). We evaluated differences in OS using the Kaplan-Meier method and Cox proportional hazards analyses.
Results: On multivariate analysis, HPV-negative status (HR = 1.42, p = 0.02) and receipt of CRT (HR = 1.34, p = 0.01) were associated with worse OS when compared to HPV-positive patients and patients receiving TL, respectively. Among patients receiving CRT, 5-year OS was lower among HPV-negative patients (33.4%) when compared to HPV-positive patients (50.6%).
Conclusions: These data suggest that HPV status may be a prognostic factor in patients with T4a LSCC. Further, it supports further investigation into the usefulness of HPV status as a selection factor for larynx preservation with CRT in these patients.
Keywords: HPV; Head and neck; Human papilloma virus; National cancer data base.
Copyright © 2019 Elsevier B.V. All rights reserved.
Similar articles
- Comparing surgical and nonsurgical larynx-preserving treatments with total laryngectomy for locally advanced laryngeal cancer.
Patel SA, Qureshi MM, Dyer MA, Jalisi S, Grillone G, Truong MT. Patel SA, et al. Cancer. 2019 Oct 1;125(19):3367-3377. doi: 10.1002/cncr.32292. Epub 2019 Jun 17. Cancer. 2019. PMID: 31206637 - Total Laryngectomy Versus Larynx Preservation for T4a Larynx Cancer: Patterns of Care and Survival Outcomes.
Grover S, Swisher-McClure S, Mitra N, Li J, Cohen RB, Ahn PH, Lukens JN, Chalian AA, Weinstein GS, O'Malley BW Jr, Lin A. Grover S, et al. Int J Radiat Oncol Biol Phys. 2015 Jul 1;92(3):594-601. doi: 10.1016/j.ijrobp.2015.03.004. Int J Radiat Oncol Biol Phys. 2015. PMID: 26068492 - Impact of cisplatin dose intensity on human papillomavirus-related and -unrelated locally advanced head and neck squamous cell carcinoma.
Spreafico A, Huang SH, Xu W, Granata R, Liu CS, Waldron JN, Chen E, Ringash J, Bayley A, Chan KK, Hope AJ, Cho J, Razak AA, Hansen A, Jang R, Perez-Ordonez B, Weinreb I, Bossi P, Orlandi E, Licitra LF, Song Y, O'Sullivan B, Siu LL, Kim J. Spreafico A, et al. Eur J Cancer. 2016 Nov;67:174-182. doi: 10.1016/j.ejca.2016.08.013. Epub 2016 Sep 24. Eur J Cancer. 2016. PMID: 27669504 - [Organ preservation in advanced laryngeal/hypopharyngeal carcinoma: lessons from the DeLOS-II trial].
Dietz A, Wichmann G, Kuhnt T, Wiegand S. Dietz A, et al. HNO. 2020 Sep;68(9):648-656. doi: 10.1007/s00106-020-00890-5. HNO. 2020. PMID: 32468135 Review. German. - Survival Outcomes in T3 Laryngeal Cancers: Primary Total Laryngectomy vs. Concurrent Chemoradiation or Radiation Therapy-A Meta-Analysis.
Rao KN, Pai PS, Dange P, Kowalski LP, Strojan P, Mäkitie AA, Guntinas-Lichius O, Robbins KT, Rodrigo JP, Eisbruch A, Takes RP, de Bree R, Coca-Pelaz A, Piazza C, Chiesa-Estomba C, López F, Saba NF, Rinaldo A, Ferlito A. Rao KN, et al. Biomedicines. 2023 Jul 28;11(8):2128. doi: 10.3390/biomedicines11082128. Biomedicines. 2023. PMID: 37626625 Free PMC article. Review.
Cited by
- Human papilloma virus-associated metachronous squamous cell carcinoma of the larynx and uterine cervix: Case report and review of the literature.
Carbajal-Mamani S, Chheda N, Esnakula A, Cardenas-Goicoechea J. Carbajal-Mamani S, et al. Gynecol Oncol Rep. 2020 Apr 7;32:100568. doi: 10.1016/j.gore.2020.100568. eCollection 2020 May. Gynecol Oncol Rep. 2020. PMID: 32300633 Free PMC article. - Prognostic significance of human papillomavirus status and treatment modality in hypopharyngeal cancer.
Burbure N, Handorf E, Ridge JA, Bauman J, Liu JC, Giri A, Galloway TJ. Burbure N, et al. Head Neck. 2021 Oct;43(10):3042-3052. doi: 10.1002/hed.26793. Epub 2021 Jun 24. Head Neck. 2021. PMID: 34165223 Free PMC article. - The Prognostic and Predictive Effects of Human Papillomavirus Status in Hypopharyngeal Carcinoma: Population-Based Study.
Yang SP, Lin XY, Hu M, Cai CF. Yang SP, et al. JMIR Public Health Surveill. 2022 Dec 16;8(12):e40185. doi: 10.2196/40185. JMIR Public Health Surveill. 2022. PMID: 36525304 Free PMC article. - The effect of HPV DNA and p16 status on the prognosis of patients with hypopharyngeal carcinoma: a meta-analysis.
Shi J, Wang L, Yao N, Sun L, Hu W, Li X, Yang Y, Wang Y, Zhu W, Li B. Shi J, et al. BMC Cancer. 2022 Jun 15;22(1):658. doi: 10.1186/s12885-022-09769-w. BMC Cancer. 2022. PMID: 35705893 Free PMC article. - Evaluation of Risk Factors for Laryngeal Squamous Cell Carcinoma: A Single-Center Retrospective Study.
Zhang Q, Wang H, Zhao Q, Zhang Y, Zheng Z, Liu S, Liu Z, Meng L, Xin Y, Jiang X. Zhang Q, et al. Front Oncol. 2021 Feb 25;11:606010. doi: 10.3389/fonc.2021.606010. eCollection 2021. Front Oncol. 2021. PMID: 33718158 Free PMC article.
MeSH terms
LinkOut - more resources
Full Text Sources
Research Materials