Cleveland Clinic Cancer Center (Taussig) Outcomes
Head and Neck Cancer
Locoregional and Distant Recurrence for HPV-Associated Oropharyngeal Cancer Using AJCC 8 Staging
2002-2018
The objective of this study is to evaluate locoregional and distant failure for human papillomavirus-associated (HPV+) oropharyngeal squamous cell carcinoma (OPSCC) using American Joint Committee on Cancer eighth edition (AJCC 8) staging.
RPA Stratification of Locoregional Control
2002-2018
AJCC 8, American Joint Committee on Cancer 8th Edition; HPV, human papillomavirus; LRC, locoregional control, OPSCC, oropharyngeal squamous cell carcinoma; RPA, recursive partitioning analysis.
Kaplan-Meier Survival Curve of Locoregional Control for HPV + OPSCC after Platinum-based Chemoradiation Stratified by RPA
2002-2018
| Number at Risk by RPA Class | 0 Years PC | 1 Year PC | 2 Years PC | 3 Years PC | 4 Years PC | 5 Years PC |
|---|---|---|---|---|---|---|
| T1-3 < 19 pack-years | 247 | 212 | 178 | 143 | 121 | 105 |
| T1-3 >= 19 pack-years | 130 | 106 | 90 | 77 | 64 | 49 |
| T4 | 80 | 57 | 49 | 47 | 39 | 34 |
HPV, human papillomavirus; LRC, locoregional control, OPSCC, oropharyngeal squamous cell carcinoma; PC, post chemoradiation; RPA, recursive partitioning analysis.
Kaplan-Meier Survival Curve of Locoregional Control for HPV + OPSCC after Platinum-based Chemoradiation Stratified by AJCC 8 Overall Stage
2002-2018
| Number at Risk by AJCC 8 Stage | 0 Years PC | 1 Years PC | 2 Years PC | 3 Years PC | 4 Years PC | 5 Years PC |
|---|---|---|---|---|---|---|
| I | 219 | 181 | 154 | 128 | 113 | 92 |
| II | 128 | 112 | 91 | 70 | 54 | 45 |
| III | 110 | 82 | 72 | 69 | 57 | 51 |
AJCC 8, American Joint Committee on Cancer 8th Edition; HPV, human papillomavirus; LRC, locoregional control, OPSCC, oropharyngeal squamous cell carcinoma; PC, post chemoradiation; RPA, recursive partitioning analysis.
RPA Stratification of Distant Control
2002-2018
HPV, human papillomavirus; OPSCC, oropharyngeal squamous cell carcinoma; AJCC 8, American Joint Committee on Cancer 8th Edition; LRC, locoregional control.
Kaplan-Meier Survival Curve of Distant Control for HPV + OPSCC after Platinum-based Chemoradiation Stratified by RPA
2002-2018
| Number at Risk by RPA Class | 0 Years PC | 1 Years PC | 2 Years PC | 3 Years PC | 4 Years PC | 5 Years PC |
|---|---|---|---|---|---|---|
| Former/Never Smoker | 362 | 314 | 259 | 218 | 184 | 155 |
| Current Smoker | 95 | 64 | 54 | 41 | 35 | 30 |
HPV, human papillomavirus; OPSCC, oropharyngeal squamous cell carcinoma; AJCC 8, American Joint Committee on Cancer 8th Edition; LRC, locoregional control; PC, post chemoradiation.
Kaplan-Meier Survival Curve of Distant Control for HPV + OPSCC after Platinum-based Chemoradiation Stratified by AJCC 8 Overall Stage
2002-2018
| Number at Risk by AJCC 8 Stage | 0 Years PC | 1 Years PC | 2 Years PC | 3 Years PC | 4 Years PC | 5 Years PC |
|---|---|---|---|---|---|---|
| I | 219 | 180 | 148 | 124 | 110 | 89 |
| II | 128 | 112 | 91 | 67 | 52 | 44 |
| III | 110 | 86 | 74 | 68 | 57 | 52 |
HPV, human papillomavirus; OPSCC, oropharyngeal squamous cell carcinoma; AJCC 8, American Joint Committee on Cancer 8th Edition; LRC, locoregional control; PC, post chemoradiation.
Rates of five-year locoregional control (LRC) and distant control (DC) were 92% (95% CI, 90-95%) and 89% (95% CI, 85-92%), respectively. Smoking, T4, N3, and stage III were associated with significantly worse time to locoregional failure (TTLRF). Recursive partitioning analysis (RPA) identified three distinct locoregional failure groups: cT1-3 and <19 pack-years vs. cT1-3 with ≥19 pack-years vs. cT4 (five-year LRC: 97% vs. 90% vs. 82%, P < .0001). The only factor associated with significantly worse time to distant failure (TTDF) was smoking status, while stage was not correlated. RPA identified two prognostic groups: former or never smokers vs. current smokers (five-year DC: 92% vs. 77%, P = .0003).
