Human papillomavirus modifies the prognostic significance of T stage and possibly N stage in tonsillar cancer

被引：46

作者：

Hong, A. M. ^{[1
,2
]}

Martin, A. ^{[3
]}

Armstrong, B. K. ^{[4
]}

Lee, C. S. ^{[5
]}

Jones, D. ^{[6
,7
]}

Chatfield, M. D. ^{[3
]}

Zhang, M. ^{[1
,2
]}

Harnett, G. ^{[8
]}

Clark, J. ^{[7
]}

Elliott, M. ^{[1
,7
]}

Milross, C. ^{[1
,2
]}

Smee, R. ^{[9
]}

Corry, J. ^{[10
]}

Liu, C. ^{[10
]}

Porceddu, S. ^{[11
]}

Vaska, K. ^{[12
]}

Veness, M. ^{[13
]}

Morgan, G. ^{[13
]}

Fogarty, G. ^{[14
]}

Veivers, D. ^{[1
,15
]}

Rees, G. ^{[16
]}

Rose, B. ^{[6
,7
]}

机构：

[1] Univ Sydney, Sydney Med Sch, Sydney, NSW 2006, Australia

[2] Royal Prince Alfred Hosp, Dept Radiat Oncol, Sydney, NSW, Australia

[3] Univ Sydney, NHMRC Clin Trials Ctr, Sydney, NSW 2006, Australia

[4] Univ Sydney, Sydney Sch Publ Hlth, Sydney, NSW 2006, Australia

[5] Royal Prince Alfred Hosp, Dept Anat Pathol, Sydney, NSW, Australia

[6] Univ Sydney, Dept Infect Dis & Immunol, Sydney, NSW 2006, Australia

[7] Royal Prince Alfred Hosp, Sydney Canc Ctr, Sydney Head & Neck Canc Inst, Sydney, NSW, Australia

[8] QEII Med Ctr, Pathwest Lab Med, Perth, WA, Australia

[9] Prince Wales Hosp, Dept Radiat Oncol, Randwick, NSW 2031, Australia

[10] Peter MacCallum Canc Ctr, Div Radiat Oncol & Canc Imaging, Melbourne, Vic, Australia

[11] Univ Queensland, Princess Alexandra Hosp, Canc Serv, Brisbane, Qld, Australia

[12] Univ Queensland, Princess Alexandra Hosp, Dept Pathol, Brisbane, Qld, Australia

[13] Westmead Hosp, Head & Neck Canc Serv, Sydney, NSW, Australia

[14] St Vincents Hosp, Dept Radiat Oncol, Sydney, NSW 2010, Australia

[15] Royal N Shore Hosp, Dept Surg, Sydney, Australia

[16] Royal Adelaide Hosp, Dept Surg, Adelaide, SA 5000, Australia

来源：

ANNALS OF ONCOLOGY | 2013年 / 24卷 / 01期

关键词：

human papillomavirus; oropharyngeal cancer; p16; radiation therapy; staging; tonsillar cancer; SQUAMOUS-CELL CARCINOMA; NECK-CANCER; HEAD; SURVIVAL; RADIOTHERAPY; SUBSET;

D O I：

10.1093/annonc/mds205

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Despite the association with more advanced nodal stage, patients with human papillomavirus (HPV) positive oropharyngeal cancers have better outcomes. We examined whether the HPV can modify the effect of known prognostic factors in tonsillar cancer. A total of 489 patients from 10 centres were followed up for recurrence or death for a median of 3.2 years. Determinants of the rate of locoregional recurrence, death from tonsillar cancer and overall survival were modelled using Cox regression. The prognostic value of T and N stages were modified by HPV as indicated by statistically significant interaction terms. After adjusting for age, gender and treatment, T stage appeared relevant only for HPV-positive cancers (where a higher T stage was associated with worse outcomes). There was some evidence that N stage was a more relevant prognostic factor for HPV-negative than -positive cancers. There was no evidence that the HPV modifies the effect of age, gender or grade on outcomes. This study suggests that the prognostic significance of the conventional staging system in tonsillar cancer is modified by HPV.

引用

页码：215 / 219

页数：5

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