TY - JOUR
T1 - Long-term Survival in Head and Neck Cancer
T2 - Impact of Site, Stage, Smoking, and Human Papillomavirus Status
AU - Du, Eugenie
AU - Mazul, Angela L.
AU - Farquhar, Doug
AU - Brennan, Paul
AU - Anantharaman, Devasena
AU - Abedi-Ardekani, Behnoush
AU - Weissler, Mark C.
AU - Hayes, David N.
AU - Olshan, Andrew F.
AU - Zevallos, Jose P.
N1 - Publisher Copyright:
© 2019 The American Laryngological, Rhinological and Otological Society, Inc.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Objectives/Hypothesis: Literature examining long-term survival in head and neck squamous cell carcinoma (HNSCC) with human papillomavirus (HPV) status is lacking. We compare 10-year overall survival (OS) rates for cases to population-based controls. Study Design: Prospective cohort study. Methods: Cases surviving 5 years postdiagnosis were identified from the Carolina Head and Neck Cancer Study. We examined 10-year survival by site, stage, p16, and treatment using Kaplan-Meier and Cox proportional hazard models. Cases were compared to age-matched, noncancer controls with stratification by p16 and smoking status. Results: Ten-year OS for HNSCC is less than controls. In 581 cases, OS differed between sites with p16+ oropharynx having the most favorable prognosis (87%), followed by oral cavity (69%), larynx (67%), p16− oropharynx (56%), and hypopharynx (51%). Initial stage, but not treatment, also impacted OS. When compared to controls matched on smoking status, the hazard ratio (HR) for death in p16+ oropharynx cases was 1.5 (95% confidence interval [CI]: 0.7-3.1) for smokers and 2.4 (95% CI: 0.7-8.8) for nonsmokers. Similarly, HR for death in non–HPV-associated HNSCC was 2.2 (95% CI: 1.7-3.0) for smokers and 2.4 (95% CI: 1.4-4.9) for nonsmokers. Conclusions: OS for HNSCC cases continues to decrease 5 years posttreatment, even after stratification by p16 and smoking status. Site, stage, smoking, and p16 status are significant factors. These data provide important prognostic information for HNSCC. Level of Evidence: 2 Laryngoscope, 129:2506–2513, 2019.
AB - Objectives/Hypothesis: Literature examining long-term survival in head and neck squamous cell carcinoma (HNSCC) with human papillomavirus (HPV) status is lacking. We compare 10-year overall survival (OS) rates for cases to population-based controls. Study Design: Prospective cohort study. Methods: Cases surviving 5 years postdiagnosis were identified from the Carolina Head and Neck Cancer Study. We examined 10-year survival by site, stage, p16, and treatment using Kaplan-Meier and Cox proportional hazard models. Cases were compared to age-matched, noncancer controls with stratification by p16 and smoking status. Results: Ten-year OS for HNSCC is less than controls. In 581 cases, OS differed between sites with p16+ oropharynx having the most favorable prognosis (87%), followed by oral cavity (69%), larynx (67%), p16− oropharynx (56%), and hypopharynx (51%). Initial stage, but not treatment, also impacted OS. When compared to controls matched on smoking status, the hazard ratio (HR) for death in p16+ oropharynx cases was 1.5 (95% confidence interval [CI]: 0.7-3.1) for smokers and 2.4 (95% CI: 0.7-8.8) for nonsmokers. Similarly, HR for death in non–HPV-associated HNSCC was 2.2 (95% CI: 1.7-3.0) for smokers and 2.4 (95% CI: 1.4-4.9) for nonsmokers. Conclusions: OS for HNSCC cases continues to decrease 5 years posttreatment, even after stratification by p16 and smoking status. Site, stage, smoking, and p16 status are significant factors. These data provide important prognostic information for HNSCC. Level of Evidence: 2 Laryngoscope, 129:2506–2513, 2019.
KW - Head and neck neoplasms
KW - human papillomavirus
KW - oropharynx
KW - smoking
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=85059942435&partnerID=8YFLogxK
U2 - 10.1002/lary.27807
DO - 10.1002/lary.27807
M3 - Article
C2 - 30637762
AN - SCOPUS:85059942435
SN - 0023-852X
VL - 129
SP - 2506
EP - 2513
JO - Laryngoscope
JF - Laryngoscope
IS - 11
ER -