Influence of HPV-status on survival of patients with tonsillar carcinomas (TSCC) treated by CO 2 -laser surgery plus risk adapted therapy - A 10 year retrospective single centre study

Hoffmann, Markus; Quabius, Elgar Susanne; Tribius, Silke; Gebhardt, Stephan; Görögh, Tibor; Hedderich, Jürgen; Huber, Karen E.; Dunst, Jürgen; Ambrosch, Petra

doi:10.1016/j.canlet.2017.10.045

Cited by 25 publications

(82 citation statements)

References 21 publications

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“…We found that patients 70 years or older have similar 3‐year disease‐specific oncologic outcomes (DSS, 94.3%; DFS, 79.3%) compared to published series analyzing younger cohorts . As expected, OS (81.5%) was lower than the 83%‐90% typically reported for HPV‐associated OPSCC, secondary to 21.3% dying of unrelated causes . Our analysis of these data demonstrated that elderly adults with HPV‐associated OPSCC could be subcategorized into three groups, allowing us to describe a clinically relevant decrement in 3‐year OS from 100% to 54% with rising age, ACE‐27 comorbidity score, and cT stage.…”

Section: Discussionsupporting

confidence: 70%

Multi‐institutional analysis of outcomes following transoral surgery for HPV‐positive oropharyngeal squamous cell carcinoma in elderly patients

et al. 2019

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Background The incidence of human papillomavirus (HPV)‐related oropharyngeal squamous cell carcinoma (OPSCC) is rising, even in elderly patients. The outcomes of transoral surgery (TOS) in this population are not entirely known. Methods A retrospective review was performed at two institutions from October 2003 to September 2016 on patients 70 years or older with HPV‐related OPSCC treated with TOS. Results A total of 75 patients were included with a mean age of 74 years (70‐87 years). At a median follow‐up of 35.7 months, 3‐year overall survival was 81.5% and disease‐specific survival was 94.3%. Advanced cT stage (odds ratio, 2.74; 95% confidence interval, 1.13‐6.64) negatively impacted OS. Conjunctive consolidation was performed to create a staging system with patients older than 80 years, severe comorbidity, and cT3‐4 having worse survival. Conclusions Elderly patients with HPV‐related OPSCC treated with TOS have excellent survival and therefore should not be excluded from such therapy based on age alone.

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Section: Discussionsupporting

confidence: 70%

Multi‐institutional analysis of outcomes following transoral surgery for HPV‐positive oropharyngeal squamous cell carcinoma in elderly patients

et al. 2019

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“…Another study by Hoffmann et al reported 5‐year OS of 83% and DFS of 80% for 48 HPV and p16‐positive OPSCC patients at a median follow‐up of 72 months. Recurrence occurred in seven (15%) patients with none in the TLM alone group, one distant metastasis in TLM + radiation, and five locoregional + 1 distant metastasis in the TLM + chemoradiation group . The survival from studies by Dale et al and Hoffmann et al were similar to our cohort, albeit they had a smaller sample size.…”

Section: Discussionmentioning

confidence: 97%

“…Transoral surgery, including TLM and TORS, has been associated with better survival for OPSCC . However, long‐term outcomes specific to transorally treated p16‐positive OPSCC are lacking or come from studies with a small number of patients. To our knowledge, no primary transoral studies with both oncologic and functional endpoints are published with minimum 5‐year follow‐up of living patients; most report outcomes after a minimum follow‐up of 12 to 24 months or less .…”

Section: Discussionmentioning

confidence: 99%

“…No recurrence rates were reported, and the surgical approach was a mix of open resection in 82%, TLM in 10%, and non‐TLM transoral resection in 7% . Another study by Hoffmann et al reported 5‐year OS of 83% and DFS of 80% for 48 HPV and p16‐positive OPSCC patients at a median follow‐up of 72 months. Recurrence occurred in seven (15%) patients with none in the TLM alone group, one distant metastasis in TLM + radiation, and five locoregional + 1 distant metastasis in the TLM + chemoradiation group .…”

Section: Discussionmentioning

confidence: 99%

“…Favorable oncologic and functional outcomes with reduced treatment toxicity in p16‐positive OPSCC are reported with these minimally invasive techniques in the short term . However, long‐term studies with information on oncologic and functional outcomes or prognosticators for transorally treated p16‐positive OPSCC are sparse …”

Section: Introductionmentioning

confidence: 99%

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Long‐term analysis of transorally resected p16 + Oropharynx cancer: Outcomes and prognostic factors

et al. 2018

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High 5-year survival and locoregional control were observed, with recurrence occurring more commonly as distant metastasis. The observed time to recurrence suggests posttreatment oncologic surveillance for at least 48 months. Identified prognosticators will inform adjuvant treatment considerations, trial planning, and patient counseling for long-term outcomes. Laryngoscope, 2018 LEVEL OF EVIDENCE: 2b.

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A systematic review of the HPV‐attributable fraction of oropharyngeal squamous cell carcinomas in Germany

et al. 2019

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The prevalence of oropharyngeal squamous cell carcinoma (OPSCC) is increasing globally while the prevalence of other head and neck cancers is decreasing. The most likely reasons for this are a decreasing influence of smoking and the growing relevance of infections with the human papilloma virus (HPV) as a risk factor. A rise in the HPV‐attributable fraction (HPV‐AF) of OPSCC has been observed in many countries, yet a comprehensive review of prevalence rates and trends in Germany is lacking. To determine the current HPV‐AF of OPSCC in Germany and to assess whether it has changed during the last decades, we performed a systematic literature review. We screened Medline and EMBASE for studies that reported the tumor HPV status of newly diagnosed OPSCC patients treated at medical centers in Germany by testing for both HPV DNA and p16INK4a overexpression to confirm involvement of HPV in tumorigenesis. Out of 287 screened studies, 14 studies with data from a total of 1819 OPSCC patients treated between 1988 and 2015 were included in the data synthesis. The reported average HPV‐AF varied considerably between the studies, ranging from 11.5% (1988‐2008) to 55.0% (2004‐2009). Two of the included studies did not only provide the HPV‐AF for the entire observed calendar period but also for separate years, allowing to more accurately assess changes over time. These studies reported increases in the HPV‐AF from 21% in 2000 to 53% in 2015 and from 38% in 2004 to 71% in 2013, respectively.

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Influence of HPV-status on survival of patients with tonsillar carcinomas (TSCC) treated by CO 2 -laser surgery plus risk adapted therapy - A 10 year retrospective single centre study

Cited by 25 publications

References 21 publications

Multi‐institutional analysis of outcomes following transoral surgery for HPV‐positive oropharyngeal squamous cell carcinoma in elderly patients

Multi‐institutional analysis of outcomes following transoral surgery for HPV‐positive oropharyngeal squamous cell carcinoma in elderly patients

Long‐term analysis of transorally resected p16 + Oropharynx cancer: Outcomes and prognostic factors

A systematic review of the HPV‐attributable fraction of oropharyngeal squamous cell carcinomas in Germany

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