Impact of AJCC 8th edition staging system and definitive treatment choice on the prognosis of complete responders with p16+ and p16- oropharyngeal squamous cell carcinomas

Oral Oncol. 2022 May:128:105861. doi: 10.1016/j.oraloncology.2022.105861. Epub 2022 Apr 15.

Abstract

Objectives: To identify predictors of overall survival (OS) in oropharyngeal squamous cell carcinoma (OPSCC) patients who achieved complete response (CR).

Methods: We performed a retrospective study of OPSCC patients who achieved CR from a single academic medical center. Associations between OS, AJCC 8th edition staging system, definitive treatment choice, smoking history, and p16 status were assessed.

Results: p16+ status was associated with favorable prognosis for CR (p < 0.001) but not non-CR (p = 0.67) patients. For early stage, p16+ OPSCC patients who achieved CR, surgery + adjuvant radiation (RT) treatment was more durable compared to concurrent chemoradiation (CRT), particularly in smokers.

Conclusions: Curative intent treatment choice and smoking history has an impact on the long-term OS of the CR p16+ OPSCC cohort. Prospective studies to define the optimal multi-modality treatment option to manage p16+ OPSCC patients is needed.

Keywords: AJCC staging; complete response; head and neck cancer; human papillomavirus; oropharyngeal squamous cell carcinoma; p16.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Head and Neck Neoplasms* / pathology
  • Humans
  • Neoplasm Staging
  • Oropharyngeal Neoplasms*
  • Papillomavirus Infections* / complications
  • Prognosis
  • Prospective Studies
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck / pathology