Prognostic factors and survival unique to surgically treated p16+ oropharyngeal cancer

作者：Bruce H. Haughey, Parul Sinha · 发表于：The Laryngoscope · 年份：2012 · DOI：10.1002/lary.23493 · 被引用次数：150 · 研究领域：Head and Neck Cancer Studies、Esophageal Cancer Research and Treatment、Head and Neck Surgical Oncology

OBJECTIVES/HYPOTHESIS: Current head and neck epidemiology demonstrates a steadily increasing incidence of p16+ human papillomavirus-related oropharynx squamous cell cancer (OPSCC). This distinct tumor subtype is associated with better survival outcomes. There is a growing recognition of the need to define management regimens that take into account the inherent patho-biological attributes of these cancers and provide optimum oncological control with minimum morbidity. This is facilitated by a clear understanding of the prognostic variables that predict disease outcome in patients with p16+ OPSCC. To provide prognostic estimates, pathological staging and histopathological parameters are usually superior to clinical staging. However, knowledge of pathological predictors is sparse, mainly because of commonly employed nonsurgical management policies utilizing chemoradiotherapy. Minimally invasive approaches to the oropharynx, particularly transoral laser microsurgery (TLM), are well-reported effective primary treatments for oropharynx cancers. From such series, it is feasible to conduct a detailed appraisal based on pathologic information from surgical specimens of both the primary and neck, to establish prognosticators unique to p16+ oropharynx cancer patients. STUDY DESIGN: A prospectively assembled database of oropharynx cancer patients treated with primary TLM ± neck dissection ± adjuvant therapy from 1996 to 2010, analyzed retrospectively for survival and recurrence. METHODS:...