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A different entity: a population based study of characteristics and recurrence patterns in oropharyngeal squamous cell carcinomas.

Murray S, Ha MN, Thompson K, Hart RD, Rajaraman M, Snow SL - J Otolaryngol Head Neck Surg (2015)

Bottom Line: Continuous variables were compared using the non-parametric Wilcoxon test. 318 charts were included in the analysis. 122 (38%) were oropharyngeal squamous cell carcinomas (OPSCCs).There were no significant differences in terms of Charlson probability of 10 year survival, smoking or alcohol consumption although OPSCC patients were significantly less likely to have COPD as a co-morbidity (n = 318, 19(16%) vs 53(27%), p = 0.0175).Specifically, despite a higher association with disease factors traditionally considered to be linked to poor prognosis, outcomes were actually superior in terms of relapse and overall mortality.

View Article: PubMed Central - PubMed

Affiliation: Dalhousie University, Faculty of Medicine, Halifax, Nova Scotia, Canada. sipmurray@gmail.com.

ABSTRACT

Background: Cases of squamous cell carcinoma (SCC) of the oropharynx were compared with other head and neck cancer (HNC) anatomic subsites in patients treated at the provincial referral centre for HNC, the Nova Scotia Cancer Centre (NSCC).

Methods: A retrospective chart review was performed on HNC patients assessed at the NSCC between 2010 and 2011. Patient demographics, disease characteristics, treatment details and outcomes, including recurrence rates and survival were collected. Data was collected on new and recurrent cases of HNC. This data was compared between the two types of HNC using chi-square tests for dichotomous categorical variables or Fishers exact test where appropriate. Wald test was used to compare categorical variables with 3 categories. Continuous variables were compared using the non-parametric Wilcoxon test.

Results: 318 charts were included in the analysis. 122 (38%) were oropharyngeal squamous cell carcinomas (OPSCCs). In terms of disease characteristics, OPSCCs were more likely to be poorly differentiated/undifferentiated (n = 267, 49(40%) vs 42(21%), p < 0.001), non-keratinizing (n = 169, 25(20%) vs 17(9%), p < 0.001), greater than 2 cm (n = 253, 72(59%) vs 78(40%), p = 0.0061), stage 4 (n = 313, 55(45%) vs 64(33%), p = 0.0315) and have had locoregional nodal spread (n = 315, 103(84%) vs 55(28%), p < 0.001). In the subset of 57 patients that had p16 testing, OPSCCs were more likely to be p16(+) (37(30%) vs 1(1%), p < .001). There were no significant differences in terms of Charlson probability of 10 year survival, smoking or alcohol consumption although OPSCC patients were significantly less likely to have COPD as a co-morbidity (n = 318, 19(16%) vs 53(27%), p = 0.0175). Finally, OPSCCs had less chance for relapse than non-OPSCCs in both univariate (2.119 times less, p=0.0034) and multivariate (1.899 times less, p=0.0505) analyses along with a 1.822 times less overall mortality in a multivariae analysis (p=0.0408).

Conclusions: This analysis suggests that Nova Scotian OPSCCs should be considered distinct from other HNC lesions, most notably in terms of disease characteristics and prognosis. Specifically, despite a higher association with disease factors traditionally considered to be linked to poor prognosis, outcomes were actually superior in terms of relapse and overall mortality.

No MeSH data available.


Related in: MedlinePlus

Cumulative incidence of relapse between oropharnygeal and non-oropharnygeal tumours (p = 0.0042)
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Fig1: Cumulative incidence of relapse between oropharnygeal and non-oropharnygeal tumours (p = 0.0042)

Mentions: Prognostic data by HNSCC primaries are presented in Tables 5, 6 and 7. 26.73 % (85) of patients experienced relapse (median follow-up time 1.4 years, IQR 0.57 to 1.74). During follow-up 11.64 % (37) died without relapse (median follow-up time 0.7 years, IQR 0.28 to 1.05). The cumulative incidence of relapse at 1-year was 7.03 % (95 % CI 3.26 % to 12.74 %) for OPSCCs compared to 20.61 % (95 % CI 14.93 % to 26.95 %) in other HNSCCs (Table 5). The Gray test indicated a difference in cummulative incidence functions (Fig. 1) for relapse between OPSCC and non-OPSCC tumours (p = 0.0042). However there was no evidence of a difference between the groups for the cummulative incidence function (Fig. 2) for relapse free mortality (p = 0.1167). The cumulative incidence of relapse free mortality at 1-year was 9.76 % (95 % CI 5.13 % to 16.16 %) for OPSCCs compared to 7.76 % (95 % CI 4.43 % to 12.28 %) for non-OPSCC tumours (Table 5).Table 5


A different entity: a population based study of characteristics and recurrence patterns in oropharyngeal squamous cell carcinomas.

Murray S, Ha MN, Thompson K, Hart RD, Rajaraman M, Snow SL - J Otolaryngol Head Neck Surg (2015)

Cumulative incidence of relapse between oropharnygeal and non-oropharnygeal tumours (p = 0.0042)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4551366&req=5

Fig1: Cumulative incidence of relapse between oropharnygeal and non-oropharnygeal tumours (p = 0.0042)
Mentions: Prognostic data by HNSCC primaries are presented in Tables 5, 6 and 7. 26.73 % (85) of patients experienced relapse (median follow-up time 1.4 years, IQR 0.57 to 1.74). During follow-up 11.64 % (37) died without relapse (median follow-up time 0.7 years, IQR 0.28 to 1.05). The cumulative incidence of relapse at 1-year was 7.03 % (95 % CI 3.26 % to 12.74 %) for OPSCCs compared to 20.61 % (95 % CI 14.93 % to 26.95 %) in other HNSCCs (Table 5). The Gray test indicated a difference in cummulative incidence functions (Fig. 1) for relapse between OPSCC and non-OPSCC tumours (p = 0.0042). However there was no evidence of a difference between the groups for the cummulative incidence function (Fig. 2) for relapse free mortality (p = 0.1167). The cumulative incidence of relapse free mortality at 1-year was 9.76 % (95 % CI 5.13 % to 16.16 %) for OPSCCs compared to 7.76 % (95 % CI 4.43 % to 12.28 %) for non-OPSCC tumours (Table 5).Table 5

Bottom Line: Continuous variables were compared using the non-parametric Wilcoxon test. 318 charts were included in the analysis. 122 (38%) were oropharyngeal squamous cell carcinomas (OPSCCs).There were no significant differences in terms of Charlson probability of 10 year survival, smoking or alcohol consumption although OPSCC patients were significantly less likely to have COPD as a co-morbidity (n = 318, 19(16%) vs 53(27%), p = 0.0175).Specifically, despite a higher association with disease factors traditionally considered to be linked to poor prognosis, outcomes were actually superior in terms of relapse and overall mortality.

View Article: PubMed Central - PubMed

Affiliation: Dalhousie University, Faculty of Medicine, Halifax, Nova Scotia, Canada. sipmurray@gmail.com.

ABSTRACT

Background: Cases of squamous cell carcinoma (SCC) of the oropharynx were compared with other head and neck cancer (HNC) anatomic subsites in patients treated at the provincial referral centre for HNC, the Nova Scotia Cancer Centre (NSCC).

Methods: A retrospective chart review was performed on HNC patients assessed at the NSCC between 2010 and 2011. Patient demographics, disease characteristics, treatment details and outcomes, including recurrence rates and survival were collected. Data was collected on new and recurrent cases of HNC. This data was compared between the two types of HNC using chi-square tests for dichotomous categorical variables or Fishers exact test where appropriate. Wald test was used to compare categorical variables with 3 categories. Continuous variables were compared using the non-parametric Wilcoxon test.

Results: 318 charts were included in the analysis. 122 (38%) were oropharyngeal squamous cell carcinomas (OPSCCs). In terms of disease characteristics, OPSCCs were more likely to be poorly differentiated/undifferentiated (n = 267, 49(40%) vs 42(21%), p < 0.001), non-keratinizing (n = 169, 25(20%) vs 17(9%), p < 0.001), greater than 2 cm (n = 253, 72(59%) vs 78(40%), p = 0.0061), stage 4 (n = 313, 55(45%) vs 64(33%), p = 0.0315) and have had locoregional nodal spread (n = 315, 103(84%) vs 55(28%), p < 0.001). In the subset of 57 patients that had p16 testing, OPSCCs were more likely to be p16(+) (37(30%) vs 1(1%), p < .001). There were no significant differences in terms of Charlson probability of 10 year survival, smoking or alcohol consumption although OPSCC patients were significantly less likely to have COPD as a co-morbidity (n = 318, 19(16%) vs 53(27%), p = 0.0175). Finally, OPSCCs had less chance for relapse than non-OPSCCs in both univariate (2.119 times less, p=0.0034) and multivariate (1.899 times less, p=0.0505) analyses along with a 1.822 times less overall mortality in a multivariae analysis (p=0.0408).

Conclusions: This analysis suggests that Nova Scotian OPSCCs should be considered distinct from other HNC lesions, most notably in terms of disease characteristics and prognosis. Specifically, despite a higher association with disease factors traditionally considered to be linked to poor prognosis, outcomes were actually superior in terms of relapse and overall mortality.

No MeSH data available.


Related in: MedlinePlus