TY - JOUR
T1 - Synchronous primary neoplasia in patients with oropharyngeal cancer
T2 - Impact of tumor HPV status. A GETTEC multicentric study
AU - Milliet, Florent
AU - Bozec, Alexandre
AU - Schiappa, Renaud
AU - Viotti, Julien
AU - Modesto, Anouchka
AU - Dassonville, Olivier
AU - Poissonnet, Gilles
AU - Guelfucci, Bruno
AU - Bizeau, Alain
AU - Vergez, Sebastien
AU - Dupret-Bories, Agnes
AU - Garrel, Renaud
AU - Fakhry, Nicolas
AU - Santini, Laure
AU - Lallemant, Benjamin
AU - Chambon, Guillaume
AU - Sudaka, Anne
AU - Peyrade, Frederic
AU - Saada-Bouzid, Esma
AU - Benezery, Karen
AU - Jourdan-Soulier, Florence
AU - Chapel, Françoise
AU - Sophie Ramay, Anne
AU - Roger, Pascal
AU - Galissier, Thibault
AU - Coste, Valérie
AU - Ben Lakdar, Aicha
AU - Guerlain, Joanne
AU - Temam, Stephane
AU - Mirghani, Haitham
AU - Gorphe, Phillipe
AU - Chamorey, Emmanuel
AU - Culié, Dorian
N1 - Publisher Copyright:
© 2020 Elsevier Ltd
PY - 2021/1/1
Y1 - 2021/1/1
N2 - Introduction: Patients with oropharyngeal squamous cell carcinoma (OPSCC) display a significant risk of synchronous primary neoplasia (SPN) which could impact their management. The aims of this study were to evaluate the risk and distribution of SPN in OPSCC patients according to their HPV (p16) status, the predictive factors of SPN and the impact of SPN on therapeutic strategy and oncologic outcomes. Material and methods: All OPSCC patients treated from 2009 to 2014 were included in this multicentric retrospective study. Univariate analyses were conducted using Chi-2 and Fisher exact tests. For multivariate analyses, all variables associated with a p ≤ 0.10 in univariate analysis were included in logistic regression models. Results: Among the 1291 patients included in this study, 75 (5.8%) displayed a SPN which was preferentially located in the upper aerodigestive tract, lung and esophagus. Comorbidity level (p = 0.03), alcohol (p = 0.005) and tobacco (p = 0.01) consumptions, and p16 tumor status (p < 0.0001) were significant predictors of SPN. In multivariate analysis, p16+ status was significantly associated with a lower risk of SPN (OR = 0.251, IC95% [0.133;0.474]). Patients with a SPN were more frequently referred for non-curative treatment (p = 0.02). In patients treated with curative intent, there was no impact of SPN on the therapeutic strategy (surgical vs. non-surgical treatment). We observed no overall survival differences between patients with or without SPN. Conclusion: P16 tumor status is the main predictive factor of SPN in OPSCC patients. This study provides crucial results which should help adapt the initial work-up and the global management of OPSCC patients.
AB - Introduction: Patients with oropharyngeal squamous cell carcinoma (OPSCC) display a significant risk of synchronous primary neoplasia (SPN) which could impact their management. The aims of this study were to evaluate the risk and distribution of SPN in OPSCC patients according to their HPV (p16) status, the predictive factors of SPN and the impact of SPN on therapeutic strategy and oncologic outcomes. Material and methods: All OPSCC patients treated from 2009 to 2014 were included in this multicentric retrospective study. Univariate analyses were conducted using Chi-2 and Fisher exact tests. For multivariate analyses, all variables associated with a p ≤ 0.10 in univariate analysis were included in logistic regression models. Results: Among the 1291 patients included in this study, 75 (5.8%) displayed a SPN which was preferentially located in the upper aerodigestive tract, lung and esophagus. Comorbidity level (p = 0.03), alcohol (p = 0.005) and tobacco (p = 0.01) consumptions, and p16 tumor status (p < 0.0001) were significant predictors of SPN. In multivariate analysis, p16+ status was significantly associated with a lower risk of SPN (OR = 0.251, IC95% [0.133;0.474]). Patients with a SPN were more frequently referred for non-curative treatment (p = 0.02). In patients treated with curative intent, there was no impact of SPN on the therapeutic strategy (surgical vs. non-surgical treatment). We observed no overall survival differences between patients with or without SPN. Conclusion: P16 tumor status is the main predictive factor of SPN in OPSCC patients. This study provides crucial results which should help adapt the initial work-up and the global management of OPSCC patients.
KW - Cancer
KW - Human papilloma virus
KW - Oropharynx
KW - Second primary neoplasia
UR - http://www.scopus.com/inward/record.url?scp=85094590748&partnerID=8YFLogxK
U2 - 10.1016/j.oraloncology.2020.105041
DO - 10.1016/j.oraloncology.2020.105041
M3 - Article
C2 - 33129057
AN - SCOPUS:85094590748
SN - 1368-8375
VL - 112
JO - Oral Oncology
JF - Oral Oncology
M1 - 105041
ER -