Annals of Otolaryngology Head and Neck Surgery (ISSN 2835-7132) | Volume 2, Issue 1 | Research Article | Open Access
Janet R Williams*
Department of Radiation Oncology, The Prince of Wales Cancer Centre, Australia
*Correspondence to: Janet R Williams
Fulltext PDFIntroduction: Oropharyngeal squamous cell carcinoma has changed over the last few decades. This review will highlight these changes, utilising data amassed over many years from a single centre.
Methods: This Ethics approved study defines three Human Papillomavirus (HPV) patient populations: HPV not tested (HPVU), representing earlier treated patients, HPV tested and negative (HPVN), and HPV tested and positive (HPVP). Eligible patients include definitive treatment at the Prince of Wales Hospital, squamous cell carcinoma histology, age ≥ 18 years, origin in the oropharynx, and a minimum two years follow-up. Endpoints were local and ultimate local control (ULC), nodal and ultimate nodal control, and overall and Cancer-Specific Survival (CSS). Analysis was performed using the Kaplan-Meier method and log-rank test to describe time-to-event data.
Results: There were 600 eligible patients: 409 HPVU, 51 HPVN, and 140 HPVP. ULC was 75% for HPVU, 90% for HPVN, and 91% for HPVP. CSS was superior for HPVP group, however, the patient groups were different, with the HPVP group more likely to be younger, a non-smoker, good performance score, with less local disease, and more nodal disease. Nodal sites of involvement were comparable across all the three groups. Over 90% of all episodes of treatment failure occurred at the initial site of disease. HPVP patients did not have an increased risk of developing another malignancy, compared to the other two groups.
Conclusion: It is well accepted that the HPVP patient has different disease with a better outcome, this review addresses these differences.
Carcinoma; Squamous Cell; Head and neck neoplasm; human papillomavirus; Local control; Oropharynx; Survival
Robert I Smee, Janet R Williams, Damian P Kotevski.Oropharynx Squamous Cell Carcinoma-Management Outcomes Over Time. Annal of Otol Head and Neck Surg. 2023;2(1):1-21.