Surgically treated oropharyngeal cancer: risk factors and tumor characteristics

Purpose To assess risk factors of patients with oropharyngeal squamous cell carcinoma in the Munich area of Southern Germany in relation to human papillomavirus (HPV) association of the tumors. To demonstrate differences in tumor characteristics and their impact on adjuvant treatment. Methods Betwee...

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Bibliographic Details
Published in:Journal of cancer research and clinical oncology 2014-06, Vol.140 (6), p.1011-1019
Main Authors: Baumeister, Philipp, Reiter, Maximilian, Welz, Christian, Becker, Sven, Betz, Christian, Harréus, Ulrich
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Alcohol Drinking - adverse effects
Biomarkers, Tumor - analysis
Cancer Research
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - surgery
Carcinoma, Squamous Cell - virology
Cyclin-Dependent Kinase Inhibitor p16 - metabolism
DNA, Viral - genetics
Female
Follow-Up Studies
Germany
Head & neck cancer
Hematology
Human papillomavirus
Humans
Internal Medicine
Lifestyles
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Grading
Neoplasm Invasiveness
Neoplasm Staging
Oncology
Original Article – Clinical Oncology
Oropharyngeal Neoplasms - pathology
Oropharyngeal Neoplasms - surgery
Oropharyngeal Neoplasms - virology
Papillomaviridae - genetics
Papillomavirus Infections - pathology
Papillomavirus Infections - surgery
Papillomavirus Infections - virology
Prognosis
Prospective Studies
Risk Factors
Smoking - adverse effects
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Summary:Purpose To assess risk factors of patients with oropharyngeal squamous cell carcinoma in the Munich area of Southern Germany in relation to human papillomavirus (HPV) association of the tumors. To demonstrate differences in tumor characteristics and their impact on adjuvant treatment. Methods Between November 2010 and July 2013, patients were prospectively interviewed for risk factors before they underwent surgical resection of their tumors. HPV association was evaluated by p16 immunohistochemistry; tumor characteristics and type of adjuvant treatment were recorded. Follow-up data were collected after a median follow-up of 12.1 month. Results In contrast to many recent studies, we could not detect any difference in overall age and age at sexual debut between p16-positive and p16-negative patients. P16-negative patients are characterized by a more intensive tobacco and alcohol use, a more abusive way of consumption, less nonoral and less oral sex partners. P16-positive patients had a significantly higher risk of lymph node metastases, but nevertheless a significant lower risk to recur or to die. No difference in the incidence of synchronous second primary tumors was seen. P16-positive patients generally received a more aggressive adjuvant treatment because of more frequently involved lymph nodes. Conclusion Lifestyle risk factors such as smoking, drinking, and sexual habits were independent from age, but showed marked differences between the p16-positive and p16-negative group. Since p16-positive patients were treated more aggressively, it is not possible to distinguish whether the better outcome of HPV-positive patients is a result of less aggressive cancers or more aggressive treatment. With regard to the ongoing debate about treatment deintensification, we should keep in mind that the survival of HPV-positive cancer patients is not 100 %.
ISSN:0171-5216
1432-1335
DOI:10.1007/s00432-014-1631-5