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Does p16+ Predict a Favorable Prognosis for Oropharyngeal Cancer? Risk Factors for Treatment Failure for Patients Who Underwent Surgery-Based Therapy

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

This study aimed to identify prognostic clinicopathologic factors that could predict treatment failure and to analyze clinical data from p16+ oropharyngeal squamous cell carcinoma (OPSCC) patients who underwent surgery.

Methods

Data from p16+ OPSCC patients who underwent surgery at Severance Hospital of Yonsei University were retrospectively reviewed.

Results

The average smoking history was 14.6 pack-years (range 0–94 pack-years). Of the 188 patients, 73 (38.8%) underwent transoral robotic surgery (TORS) for surgical treatment of their primary lesions, and the remaining 115 patients (61.2%) underwent conventional surgery. Extracapsular nodal spread was detected in 87 patients (46.3%). At histologic examination, 67 patients (35.6%) showed positive surgical margins, and 121 patients (64.4%) had negative surgical margins. Postoperative adjuvant treatment was performed for 167 patients (88.8%). During the follow-up period, there were 18 recurrences including 2 local recurrences, 10 regional recurrences, and 6 distant metastases. During the study period, 17 deaths occurred. The univariate analysis showed that the American Joint Committee on Cancer (AJCC) 8th-edition staging system, lymphovascular invasion, more than four metastatic lymph nodes, and a smoking history of more than 10 pack-years were significantly associated with treatment failure. In the multivariate analysis, only the AJCC 8th-edition staging system was significantly associated with the patient’s survival.

Conclusion

Surgical treatment methods including TORS for p16+ OPSCC patients showed excellent oncologic results, and many previously known clinicopathologic factors did not show a significant relationship with patient prognosis. Only the newly revised AJCC 8th-edition staging system showed a significant relationship with patient survival, and this should be considered in the setting of p16+ OPSCC treatment guidelines in the future.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea

    Young Min Park MD, PhD, Min Seok Kang MD, Yoon Woo Koh MD, PhD, Eun Chang Choi MD, PhD & Se-Heon Kim MD, PhD

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  1. Young Min Park MD, PhD
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  2. Min Seok Kang MD
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  3. Yoon Woo Koh MD, PhD
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  4. Eun Chang Choi MD, PhD
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  5. Se-Heon Kim MD, PhD
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Correspondence to Se-Heon Kim MD, PhD.

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Park, Y.M., Kang, M.S., Koh, Y.W. et al. Does p16+ Predict a Favorable Prognosis for Oropharyngeal Cancer? Risk Factors for Treatment Failure for Patients Who Underwent Surgery-Based Therapy. Ann Surg Oncol 26, 547–554 (2019). https://doi.org/10.1245/s10434-018-6806-x

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  • DOI: https://doi.org/10.1245/s10434-018-6806-x

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