CORE
🇺🇦
make metadata, not war
Services
Services overview
Explore all CORE services
Access to raw data
API
Dataset
FastSync
Content discovery
Recommender
Discovery
OAI identifiers
OAI Resolver
Managing content
Dashboard
Bespoke contracts
Consultancy services
Support us
Support us
Membership
Sponsorship
Community governance
Advisory Board
Board of supporters
Research network
About
About us
Our mission
Team
Blog
FAQs
Contact us
Predictors of Mortality in HPV-Associated Oropharynx Carcinoma Treated With Surgery Alone
Authors
David M. Cognetti
Mary Han
+6 more
Jeffery J. Houlton
Arjun S. Joshi
Andrew R. Larson
William R. Ryan
David W. Schoppy
Gaelen B. Stanford-Moore
Publication date
1 July 2020
Publisher
Health Sciences Research Commons
Abstract
© 2019 The American Laryngological, Rhinological and Otological Society, Inc. Objective: Survival outcomes for human papillomavirus-associated oropharynx squamous cell carcinoma (HPV + OPSCC) treated with surgery alone are unclear. To increase understanding, we assessed overall survival (OS) outcomes using the national cancer database (NCDB). Methods: We conducted a retrospective analysis of OS of 736 NCDB HPV + OPSCC patients who underwent surgery alone from 2010 to 2014 using univariate and multivariate analyses and the Kaplan-Meir method. Results: Multivariable analysis found the following independent risk factors for death: American Joint Commission on Cancer (AJCC) 8th edition pathologic stage(p)N2 versus pN0 disease (hazard ratio [HR], 5.5; P = 0.000006), macroscopic extranodal extension (ENE) versus non-ENE (HR, 4.9; P \u3c 0.02), a positive lymph nodes (LN) percentage of ≥10% (HR, 4.2; P = 0.0002), and five or more positive LNs (HR, 4.9; P = 0.00004). Three-year OS was significantly worse for AJCC 8th edition pN2 versus pN0 but not for 7th edition pN2 versus pN0 disease. Five-year OS was significantly worse for positive versus negative surgical margins, AJCC 8th edition stage II versus I, and either microscopic or macroscopic ENE versus non-ENE positive LNs. For 523 (71%) AJCC 8th edition stage I patients and for 283 (38%) patients who were pT1–T2, with negative margins, pN0–N1, with ≤4 pathologic LNs, without ENE, and with \u3e20 LNs removed during neck dissection, the 3-year OS rates were 93% and 95%, respectively, and the 5-year OS rates were 91% and 95%, respectively. Conclusion: In the context of the lack of detail and possible inaccuracies found in the NCDB, surgery alone for AJCC 8th edition stage I HPV + OPSCC, particularly pT1–T2, pN0–N1 with ≤4 pathologic LNs, without ENE, and with negative surgical margins has a high OS. Level of Evidence: 4 Laryngoscope, 130:E423–E435, 2020
Similar works
Full text
Available Versions
George Washington University: Health Sciences Research Commons (HSRC)
See this paper in CORE
Go to the repository landing page
Download from data provider
oai:hsrc.himmelfarb.gwu.edu:sm...
Last time updated on 03/12/2020