Outcome and prognostic factors in T4a oropharyngeal carcinoma, including the role of HPV infection.

Abstract:

BACKGROUND:The prognosis of patients with advanced oropharyngeal carcinoma (OPSCC) is generally poor. The aim of this study is to investigate the different therapeutic approaches and identify prognostic factors associated with a worse outcome for patients treated for T4a OPSCC, in order to improve treatment selection for the individual. METHODS:A retrospective study was conducted on 426 patients with T4a OPC treated between 1980 and 2010. Eleven prognostic factors including treatment modality, lymph node staging, and p16 status as a surrogate marker for human papillomavirus (HPV) infection were analyzed. RESULTS:Univariate analysis showed a significant difference in DSS between N0 and N+ (57.1% versus 26.9%, P < 0.001), primary surgical and primary nonsurgical treatment (52.7% versus 31.4%, P < 0.001), and perinodal invasion (51.7% versus 19.9%, P = 0.011). P16-negative patients tended towards a worse DSS than p16-positive patients (40.2% versus 64.6%, P = 0.126) but responded better to primary surgery than to nonsurgical treatment (71.4% versus 34.0%, P = 0.113). Multivariate analysis identified the N category as an independent prognostic factor for survival. CONCLUSION:The survival of p16-negative patients was worse than p16-positive patients, although they seem to respond better to primary surgery. The strongest independent prognostic factor for T4a carcinomas proved to be the presence of lymph node metastases.

journal_name

Biomed Res Int

authors

Psychogios G,Mantsopoulos K,Agaimy A,Brunner K,Mangold E,Zenk J,Iro H

doi

10.1155/2014/390825

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

390825

eissn

2314-6133

issn

2314-6141

journal_volume

2014

pub_type

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