Low Survival Rates of Oral and Oropharyngeal Squamous Cell Carcinoma

Aim. To assess the epidemiological and clinical factors that influence the prognosis of oral and oropharyngeal squamous cell carcinoma (SCC). Methods. One hundred and twenty-one cases of oral and oropharyngeal SCC were selected. The survival curves for each variable were estimated using the Kaplan-Meier method. The Cox regression model was applied to assess the effect of the variables on survival. Results. Cancers at an advanced stage were observed in 103 patients (85.1%). Cancers on the tongue were more frequent (23.1%). The survival analysis was 59.9% in one year, 40.7% in two years, and 27.8% in 5 years. There was a significant low survival rate linked to alcohol intake (p=0.038), advanced cancer staging (p=0.003), and procedures without surgery (p<0.001). When these variables were included in the Cox regression model only surgery procedures (p=0.005) demonstrated a significant effect on survival. Conclusion. The findings suggest that patients who underwent surgery had a greater survival rate compared with those that did not. The low survival rates and the high percentage of patients diagnosed at advanced stages demonstrate that oral and oropharyngeal cancer patients should receive more attention.

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Does Microvascular free flap Reconstruction in oral Squamous cell Carcinoma Improve Patient Survival?

Otolaryngology ◽

10.1016/j.otohns.2008.08.019 ◽

2008 ◽

Vol 139 (6) ◽

pp. 775-780 ◽

Cited By ~ 10

Author(s):

Claudio Marchetti ◽

Angelo Pizzigallo ◽

Riccardo Cipriani ◽

Angelo Campobassi ◽

Giovanni Badiali

Keyword(s):

Squamous Cell Carcinoma ◽

Survival Rate ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Cox Regression ◽

Survival Rates ◽

Free Tissue Transfer ◽

Microvascular Reconstruction ◽

Improve Patient Survival

Objective We analyzed our experiences with microvascular reconstruction after oncologic resections for oral squamous cell carcinoma. Has microvascular surgery changed the survival rate of these patients? Design Retrospective study. Subjects and Methods Forty-two consecutive patients enrolled from March 1999 to December 2004. Follow-up time ranged from 1 to 94 months. Survival rates were evaluated by the Kaplan-Meier method and compared among different groups with the use of Cox regression. Results The actuarial 5-year survival rate was 41.9% (SD = 9.6%). Survival rates were also analyzed according to T, N, and stage. The survival was significantly related only to N, which showed a 72.4% increase in the risk related to the increase of one N stage. Conclusions A comparison between our study group and those of 3 previous similar studies would not provide definitive statistical evidence, but it could certainly suggest a trend. The comparison seems to support that microvascular free tissue transfer does not change the survival of these patients.

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Preoperative platelet–lymphocyte ratio predicts recurrence of laryngeal squamous cell carcinoma

Future Oncology ◽

10.2217/fon-2019-0527 ◽

2020 ◽

Vol 16 (6) ◽

pp. 209-217

Author(s):

Huijun Chen ◽

Shenghua Song ◽

Liqing Zhang ◽

Weida Dong ◽

Xi Chen ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Regression Model ◽

Cell Carcinoma ◽

Squamous Cell ◽

Laryngeal Squamous Cell Carcinoma ◽

Cox Regression ◽

Cox Regression Model ◽

Lymphocyte Ratio ◽

Platelet Lymphocyte Ratio ◽

Kaplan Meier

Aim: To evaluate the impact of preoperative platelet–lymphocyte ratio (PLR), neutrophil–lymphocyte ratio (NLR), derived NLR (dNLR) and lymphocyte–monocyte ratio (LMR) on the prognosis of laryngeal squamous cell carcinoma. Materials & methods: Overall survival and recurrence-free survival (RFS) were analyzed using Kaplan–Meier estimates. Multivariable Cox regression model was used to evaluate the independent prognostic significance of variables. Results: High PLR (>103.96), NLR (>1.96) and dNLR (>1.70) predicted lower RFS according to Kaplan–Meier method. In COX regression model, patients with high PLR had poor RFS estimates compared with those with lower PLR (p < 0.001). Conclusion: Preoperative PLR was a more valuable prognostic factor than NLR, dNLR and LMR for the recurrence of laryngeal squamous cell carcinoma.

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Risk Classification of Human Papillomavirus-related Oropharyngeal Squamous Cell Carcinoma in Japanese Patients

10.21203/rs.3.rs-900079/v1 ◽

2021 ◽

Author(s):

Jun ITAMI ◽

Kenya KOBAYASHI ◽

Taisuke MORI ◽

Yoshitaka HONMA ◽

Yuko KUBO ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Human Papillomavirus ◽

Cell Carcinoma ◽

Squamous Cell ◽

Tnm Classification ◽

Survival Rates ◽

Japanese Patients ◽

Risk Classification ◽

Oropharyngeal Squamous Cell Carcinoma ◽

Neck Node

Abstract Purpose The validity of the risk classification according to Ang for human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) remains to be studied in patients treated by methods other than chemoradiotherapy and in Japanese patients. In this study, the validity of Ang's risk classification was studied in Japanese patients treated using various methods, including surgery.Material and Method Between 2010 and 2018, 122 patients with HPV-related OPSCC stages III and IV according to the TNM classification 7th edition (TNM-7) were treated curatively at a single institution in Japan. The median age was 62.7 years. Sixty-seven patients (54.9%) were classified as stage I according to the TNM 8th edition (TNM-8). Over 50% of the patients underwent surgery with or without adjuvant therapy. The influence of multiple factors on survival was determined.Results Age, amount of smoking, secondary cancer, and N-stage according to the TNM-7 significantly influenced survival. Ang's risk classification was also predictive of prognosis, but if 30 pack-years (PYs) instead of 10 PYs is employed to dichotomize the amount of smoking, the new risk classification can significantly better predict prognosis. According to the new risk classification, favorable and unfavorable risk patients showed 5-year progression-free survival, disease-specific survival, and overall survival rates of 72.7% and 35.9%, 94.6% and 76.2%, and 92.6% and 62.7%, respectively.Conclusions Even in patients treated by methods other than chemoradiotherapy and in Japanese patients, the combination of the amount of smoking and neck node status is useful in prognosis prediction.

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SU-E-T-352: Why Is the Survival Rate Low in Oropharyngeal Squamous Cell Carcinoma?

Medical Physics ◽

10.1118/1.4888685 ◽

2014 ◽

Vol 41 (6Part16) ◽

pp. 305-305

Author(s):

Z Huang ◽

T Liu ◽

Y Feng ◽

K Rasmussen ◽

J Rice ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Survival Rate ◽

Cell Carcinoma ◽

Squamous Cell ◽

Oropharyngeal Squamous Cell Carcinoma

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Tobacco exposure as a major modifier of oncologic outcomes in human papillomavirus (HPV) associated oropharyngeal squamous cell carcinoma

BMC Cancer ◽

10.1186/s12885-020-07427-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Hesham Elhalawani ◽

Abdallah S. R. Mohamed ◽

Baher Elgohari ◽

Timothy A. Lin ◽

Andrew G. Sikora ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Human Papillomavirus ◽

Cell Carcinoma ◽

Squamous Cell ◽

Cox Regression ◽

Disease Free Survival ◽

Oropharyngeal Squamous Cell Carcinoma ◽

Oncologic Outcomes ◽

Tobacco Exposure ◽

Hpv Status

Abstract Background The incidence of oropharyngeal squamous cell carcinoma (OPSCC) in the US is rapidly increasing, driven largely by the epidemic of human papillomavirus (HPV)-mediated OPSCC. Although survival for patients with HPV mediated OPSCC (HPV+ OPSCC) is generally better than that of patients with non-virally mediated OPSCC, this effect is not uniform. We hypothesized that tobacco exposure remains a critical modifier of survival for HPV+ OPSCC patients. Methods We conducted a retrospective analysis of 611 OPSCC patients with concordant p16 and HPV testing treated at a single institute (2002–2013). Survival analysis was performed using Kaplan-Meier analysis and Cox regression. Recursive partitioning analysis (RPA) was used to define tobacco exposure associated with survival (p < 0.05). Results Tobacco exposure impacted overall survival (OS) for HPV+ patients on univariate and multivariate analysis (p = 0.002, p = 0.003 respectively). RPA identified 30 pack-years (PY) as a threshold at which survival became significantly worse in HPV+ patients. OS and disease-free survival (DFS) for HPV+ > 30 PY patients didn’t differ significantly from HPV- patients (p = 0.72, p = 0.27, respectively). HPV+ > 30 PY patients had substantially lower 5-year OS when compared to their ≤30 PYs counterparts: 78.4% vs 91.6%; p = 0.03, 76% vs 88.3%; p = 0.07, and 52.3% vs 74%; p = 0.05, for stages I, II, and III (AJCC 8th Edition Manual), respectively. Conclusions Tobacco exposure can eliminate the survival benefit associated with HPV+ status in OPSCC patients. Until this effect can be clearly quantified using prospective datasets, de-escalation of treatment for HPV + OPSCC smokers should be avoided.

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Socioeconomic and Racial Disparities and Survival of Human Papillomavirus–Associated Oropharyngeal Squamous Cell Carcinoma

Otolaryngology ◽

10.1177/0194599820935853 ◽

2020 ◽

pp. 019459982093585

Author(s):

Janine M. Rotsides ◽

Jamie R. Oliver ◽

Lindsey E. Moses ◽

Moses Tam ◽

Zujun Li ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Human Papillomavirus ◽

Cell Carcinoma ◽

Squamous Cell ◽

Cox Regression ◽

Population Based ◽

Oropharyngeal Squamous Cell Carcinoma ◽

Median Income ◽

Racial Groups ◽

Hpv Status

Objective To investigate differences in epidemiology of oropharyngeal squamous cell carcinoma (OPSCC) with regards to human papillomavirus (HPV), race, and socioeconomic status (SES) using the National Cancer Database (NCDB). Study Design Population-based cohort study. Setting Racial and socioeconomic disparities in survival of OPSCC have been previously acknowledged. However, the distribution of HPV-related cancers and its influence on survival in conjunction with race and SES remain unclear. Subjects and Methods All patients with OPSCC in the NCDB with known HPV status from 2010 to 2016 were included. Differences in presentation, HPV status, treatment, and outcomes were compared along racial and socioeconomic lines. Univariable and multivariable Cox regression survival analyses were performed. Results In total, 45,940 patients met criteria. Most were male (38,038, 82.8%), older than 60 years (23,456, 51.5%), and white (40,156, 87.4%), and lived in higher median income areas (>$48,000, 28,587, 62.2%). Two-thirds were HPV positive (31,007, 67.5%). HPV-negative disease was significantly more common in lower SES (<$38,000, 2937, 41.5%, P < .001) and among blacks (1784, 55.3%, P < .001). Median follow-up was 33 months. Five-year overall survival was 81.3% (95% CI, 80.5%-82.1%) and 59.6% (95% CI, 58.2%-61.0%) in HPV-positive and HPV-negative groups, respectively. In univariable and multivariable analyses controlling for HPV status, age, stage, and treatment, black race (hazard ratio [HR], 1.22; 95% CI, 1.11-1.34; P < .001) and low SES (HR, 1.58; 95% CI, 1.45-1.72; P < .001) were associated with worse survival. Conclusion Significant differences in HPV status exist between socioeconomic and racial groups, with HPV-negative disease more common among blacks and lower SES. When controlling for HPV status, race and SES still influence outcomes in oropharyngeal cancers.

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Low-dose aspirin confers a survival benefit in patients with pathological advanced-stage oral squamous cell carcinoma

Scientific Reports ◽

10.1038/s41598-021-96614-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sheng-Dean Luo ◽

Shao-Chun Wu ◽

Wei-Chih Chen ◽

Ching-Nung Wu ◽

Tai-Jan Chiu ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Squamous Cell Carcinoma ◽

Oral Cavity ◽

Cell Carcinoma ◽

Squamous Cell ◽

Cox Regression ◽

Survival Rates ◽

Distant Metastases ◽

Good Prognosis ◽

High Rate

AbstractOral squamous cell carcinoma (OSCC) remains one of the most challenging clinical problems in the field due to its high rate of locoregional and distant metastases. However, studies that assess the association between aspirin use and survival in patients with OSCC are limited. Moreover, patients that recruited from those studies might have tumors that arose from different anatomic regions of the head and neck, including the oral cavity, oropharynx, etc. Since tumors within these distinct anatomic regions are unique in the context of epidemiology and tumor progression, we sought to evaluate the association of aspirin use with squamous cell carcinomas located within the oral cavity only. In this 10-year cohort study, we evaluated aspirin use and survival rates in relation to clinical characteristics as well as duration of aspirin use in patients with OSCC. Our findings suggest that OSCC patients with aspirin use for more than 180 days showed improved overall and disease-specific survival rates. Aspirin also improves survival in patients across various stages of OSCC. Cox regression models indicated that aspirin use was associated with a good prognosis. In conclusion, this evidence indicates that aspirin may be potentially used as an adjuvant therapy for OSCC.

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Tobacco exposure as a major modifier of oncologic outcomes in Human PapillomaVirus (HPV) associated oropharyngeal squamous cell carcinoma

10.21203/rs.2.22588/v2 ◽

2020 ◽

Author(s):

Hesham Elhalawani ◽

Abdallah S.R. Mo ◽

Baher Elgohari ◽

Timothy A. Lin ◽

Andrew G. Sikora ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Human Papillomavirus ◽

Cell Carcinoma ◽

Squamous Cell ◽

Cox Regression ◽

Disease Free Survival ◽

Oropharyngeal Squamous Cell Carcinoma ◽

Oncologic Outcomes ◽

Tobacco Exposure ◽

Hpv Status

Abstract Background: The incidence of oropharyngeal squamous cell carcinoma (OPSCC) in the US is rapidly increasing, driven largely by the epidemic of human papillomavirus (HPV)-mediated OPSCC. Although survival for patients with HPV mediated OPSCC (HPV+ OPSCC) is generally better than that of patients with non-viral HPV+ OPSCC, the improvement is not uniform. We hypothesized that tobacco exposure remains a critical modifier of survival for HPV+ OPSCC patients. Methods: We conducted a retrospective analysis of 611 OPSCC patients with concordant p16 and HPV testing treated at a single institute (2002-2013). Survival analysis was performed using Kaplan-Meier analysis and Cox regression. Recursive partitioning analysis (RPA) was used to define tobacco exposure associated with survival (p<0.05). Results: Tobacco exposure impacted overall survival (OS) for HPV+ patients on univariate and multivariate analysis (p=0.002, p=0.003 respectively). RPA identified 30 pack-years (PY) as a threshold at which survival became significantly worse in HPV+ patients. OS and disease-free survival (DFS) for HPV+ >30 PY patients didn’t differ significantly from HPV- group (p= 0.72, p= 0.27, respectively). HPV+ >30 PY patients had substantially lower 5-year OS when compared to their ≤30 PYs counterparts: 78.4% vs 91.6%; p= 0.03, 76% vs 88.3%; p= 0.07, and 52.3% vs 74%; p= 0.05, for stages I, II, and III (AJCC 8 th Edition Manual), respectively. Conclusions: Tobacco exposure can eliminate the survival benefit associated with HPV+ status in OPSCC patients. Until this effect can be clearly quantified using prospective datasets, de-escalation of treatment for HPV+OPSCC smokers should be avoided.

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Predictors of Survival After Head and Neck Squamous Cell Carcinoma in South America: The InterCHANGE Study

JCO Global Oncology ◽

10.1200/go.20.00014 ◽

2020 ◽

pp. 486-499 ◽

Cited By ~ 3

Author(s):

Renata Abrahão ◽

Sandra Perdomo ◽

Luis Felipe Ribeiro Pinto ◽

Flávia Nascimento de Carvalho ◽

Fernando Luis Dias ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

South America ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Cox Regression ◽

Survival Rates ◽

Stage Iv ◽

Neck Squamous Cell Carcinoma ◽

Stage Iv Disease

PURPOSE Head and neck squamous cell carcinoma (HNSCC) incidence is high in South America, where recent data on survival are sparse. We investigated the main predictors of HNSCC survival in Brazil, Argentina, Uruguay, and Colombia. METHODS Sociodemographic and lifestyle information was obtained from standardized interviews, and clinicopathologic data were extracted from medical records and pathologic reports. The Kaplan-Meier method and Cox regression were used for statistical analyses. RESULTS Of 1,463 patients, 378 had a larynx cancer (LC), 78 hypopharynx cancer (HC), 599 oral cavity cancer (OC), and 408 oropharynx cancer (OPC). Most patients (55.5%) were diagnosed with stage IV disease, ranging from 47.6% for LC to 70.8% for OPC. Three-year survival rates were 56.0% for LC, 54.7% for OC, 48.0% for OPC, and 37.8% for HC. In multivariable models, patients with stage IV disease had approximately 7.6 (LC/HC), 11.7 (OC), and 3.5 (OPC) times higher mortality than patients with stage I disease. Current and former drinkers with LC or HC had approximately 2 times higher mortality than never-drinkers. In addition, older age at diagnosis was independently associated with worse survival for all sites. In a subset analysis of 198 patients with OPC with available human papillomavirus (HPV) type 16 data, those with HPV-unrelated OPC had a significantly worse 3-year survival compared with those with HPV-related OPC (44.6% v 75.6%, respectively), corresponding to a 3.4 times higher mortality. CONCLUSION Late stage at diagnosis was the strongest predictor of lower HNSCC survival. Early cancer detection and reduction of harmful alcohol use are fundamental to decrease the high burden of HNSCC in South America.

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Molecular and clinical aspects of oropharyngeal squamous cell carcinoma associated with human papillomavirus

Head and neck tumors (HNT) ◽

10.17650/2313-805x-2021-11-2-31-40 ◽

2021 ◽

Vol 11 (2) ◽

pp. 31-40

Author(s):

D. Sh. Polatova ◽

A. Yu. Madaminov

Keyword(s):

Overall Survival ◽

Squamous Cell Carcinoma ◽

Human Papillomavirus ◽

Cell Carcinoma ◽

Squamous Cell ◽

Survival Rates ◽

Oropharyngeal Squamous Cell Carcinoma ◽

Response To Treatment ◽

Clinical Aspects ◽

Hpv E6

Currently, the role of human papillomavirus (HPV) in carcinogenesis is well known: more than 90 % of HPV-positive oropharyngeal squamous cell carcinomas are caused by HPV type 16 (HPV-16). HPV E6 and E7 oncoproteins play a significant role in the development of this tumor. The E6- mediated degradation of suppressor protein p53 results in G2/M-phase checkpoint dysregulation and inhibition of apoptosis. HPV oncoprotein E7 binds to pRb, promoting its degradation and the release of E2F transcription factor. Diagnostic assays for HPV detection include immunohistochemical staining for p16, polymerase chain reaction, in situ hybridization, and next-generation sequencing. Immunohistochemical examination (determination of p16 protein expression) is an economical and very specific way to detect a viral infection. Patients with HPV-positive oropharyngeal squamous cell carcinoma demonstrate significantly better response to treatment and overall survival rates than those with HPV-negative oropharyngeal squamous cell carcinoma. Despite the fact that five-year overall survival rate in patients with HPV-positive oropharyngeal squamous cell carcinoma after treatment exceeds 80 %, some patients have poor survival. Unfortunately, currently available methods of risk stratification still do not endure their timely identification. Further research is needed to address these problems.

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