Oropharyngeal squamous cell carcinoma in the veteran population: Association with traditional carcinogen exposure and poor clinical outcomes

Vlad C. Sandulache; John Hamblin; Syeling Lai; Todd Pezzi; Heath D. Skinner; Numan A. Khan; Shayan M. Dioun; Christine Hartman; Jennifer Kramer; Elizabeth Chiao; Xiaodong Zhou; Jose P. Zevallos

doi:10.1002/hed.23740

Oropharyngeal squamous cell carcinoma in the veteran population: Association with traditional carcinogen exposure and poor clinical outcomes

Vlad C. Sandulache, John Hamblin, Syeling Lai, Todd Pezzi, Heath D. Skinner, Numan A. Khan, Shayan M. Dioun, Christine Hartman, Jennifer Kramer, Elizabeth Chiao, Xiaodong Zhou, Jose P. Zevallos

Research output: Contribution to journal › Article › peer-review

40 Scopus citations

Abstract

Background A significant fraction of oropharyngeal squamous cell carcinoma (SCC) cases is associated with traditional carcinogens; in these patients, treatment response and clinical outcomes remain poor. Methods We evaluated patient, tumor, and treatment characteristics for 200 veterans with oropharyngeal SCC treated at the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) between 2000 and 2012. Results Most patients (77%) were white and heavy smokers. Twenty-seven patients required tracheostomy and 63 required gastrostomy placement during treatment. Overall survival (OS) at 5 years was 40%. Survival was impacted by T classification, treatment intensity, completion of treatment, and p16 tumor status. Almost 30% of patients were unable to complete a treatment regimen consistent with National Comprehensive Cancer Network (NCCN) guidelines. Conclusion Oropharyngeal SCC in veterans is associated with traditional carcinogens and poor clinical outcomes. Despite heavy smoking exposure, p16 tumor status significantly impacts survival. Careful consideration must be given to improving treatment paradigms for this cohort given their limited tolerance for treatment escalation.

Original language	English
Pages (from-to)	1246-1253
Number of pages	8
Journal	Head and Neck
Volume	37
Issue number	9
DOIs	https://doi.org/10.1002/hed.23740
State	Published - Sep 1 2015

Keywords

gastrostomy
oropharyngeal cancer
smoking
tracheostomy
veteran

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Sandulache, V. C., Hamblin, J., Lai, S., Pezzi, T., Skinner, H. D., Khan, N. A., Dioun, S. M., Hartman, C., Kramer, J., Chiao, E., Zhou, X., & Zevallos, J. P. (2015). Oropharyngeal squamous cell carcinoma in the veteran population: Association with traditional carcinogen exposure and poor clinical outcomes. Head and Neck, 37(9), 1246-1253. https://doi.org/10.1002/hed.23740

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title = "Oropharyngeal squamous cell carcinoma in the veteran population: Association with traditional carcinogen exposure and poor clinical outcomes",

abstract = "Background A significant fraction of oropharyngeal squamous cell carcinoma (SCC) cases is associated with traditional carcinogens; in these patients, treatment response and clinical outcomes remain poor. Methods We evaluated patient, tumor, and treatment characteristics for 200 veterans with oropharyngeal SCC treated at the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) between 2000 and 2012. Results Most patients (77%) were white and heavy smokers. Twenty-seven patients required tracheostomy and 63 required gastrostomy placement during treatment. Overall survival (OS) at 5 years was 40%. Survival was impacted by T classification, treatment intensity, completion of treatment, and p16 tumor status. Almost 30% of patients were unable to complete a treatment regimen consistent with National Comprehensive Cancer Network (NCCN) guidelines. Conclusion Oropharyngeal SCC in veterans is associated with traditional carcinogens and poor clinical outcomes. Despite heavy smoking exposure, p16 tumor status significantly impacts survival. Careful consideration must be given to improving treatment paradigms for this cohort given their limited tolerance for treatment escalation.",

keywords = "gastrostomy, oropharyngeal cancer, smoking, tracheostomy, veteran",

author = "Sandulache, {Vlad C.} and John Hamblin and Syeling Lai and Todd Pezzi and Skinner, {Heath D.} and Khan, {Numan A.} and Dioun, {Shayan M.} and Christine Hartman and Jennifer Kramer and Elizabeth Chiao and Xiaodong Zhou and Zevallos, {Jose P.}",

note = "Publisher Copyright: {\textcopyright} 2014 Wiley Periodicals, Inc. Head Neck 37: 1246-1253, 2015 {\textcopyright} 2014 Wiley Periodicals, Inc.",

year = "2015",

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doi = "10.1002/hed.23740",

language = "English",

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T1 - Oropharyngeal squamous cell carcinoma in the veteran population

T2 - Association with traditional carcinogen exposure and poor clinical outcomes

AU - Sandulache, Vlad C.

AU - Hamblin, John

AU - Lai, Syeling

AU - Pezzi, Todd

AU - Skinner, Heath D.

AU - Khan, Numan A.

AU - Dioun, Shayan M.

AU - Hartman, Christine

AU - Kramer, Jennifer

AU - Chiao, Elizabeth

AU - Zhou, Xiaodong

AU - Zevallos, Jose P.

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Background A significant fraction of oropharyngeal squamous cell carcinoma (SCC) cases is associated with traditional carcinogens; in these patients, treatment response and clinical outcomes remain poor. Methods We evaluated patient, tumor, and treatment characteristics for 200 veterans with oropharyngeal SCC treated at the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) between 2000 and 2012. Results Most patients (77%) were white and heavy smokers. Twenty-seven patients required tracheostomy and 63 required gastrostomy placement during treatment. Overall survival (OS) at 5 years was 40%. Survival was impacted by T classification, treatment intensity, completion of treatment, and p16 tumor status. Almost 30% of patients were unable to complete a treatment regimen consistent with National Comprehensive Cancer Network (NCCN) guidelines. Conclusion Oropharyngeal SCC in veterans is associated with traditional carcinogens and poor clinical outcomes. Despite heavy smoking exposure, p16 tumor status significantly impacts survival. Careful consideration must be given to improving treatment paradigms for this cohort given their limited tolerance for treatment escalation.

AB - Background A significant fraction of oropharyngeal squamous cell carcinoma (SCC) cases is associated with traditional carcinogens; in these patients, treatment response and clinical outcomes remain poor. Methods We evaluated patient, tumor, and treatment characteristics for 200 veterans with oropharyngeal SCC treated at the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) between 2000 and 2012. Results Most patients (77%) were white and heavy smokers. Twenty-seven patients required tracheostomy and 63 required gastrostomy placement during treatment. Overall survival (OS) at 5 years was 40%. Survival was impacted by T classification, treatment intensity, completion of treatment, and p16 tumor status. Almost 30% of patients were unable to complete a treatment regimen consistent with National Comprehensive Cancer Network (NCCN) guidelines. Conclusion Oropharyngeal SCC in veterans is associated with traditional carcinogens and poor clinical outcomes. Despite heavy smoking exposure, p16 tumor status significantly impacts survival. Careful consideration must be given to improving treatment paradigms for this cohort given their limited tolerance for treatment escalation.

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KW - oropharyngeal cancer

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KW - veteran

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Oropharyngeal squamous cell carcinoma in the veteran population: Association with traditional carcinogen exposure and poor clinical outcomes

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