Kaczmar John M, Tan Kay See, Heitjan Daniel F, Lin Alexander, Ahn Peter H, Newman Jason G, Rassekh Christopher H, Chalian Ara A, O'Malley Bert W, Cohen Roger B, Weinstein Gregory S
Department of Medical Oncology, Fox Chase Cancer Center/Temple University, Philadelphia, Pennsylvania.
Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania.
Head Neck. 2016 Jan;38(1):59-65. doi: 10.1002/hed.23850. Epub 2015 Apr 6.
The purpose of this study was to determine clinical factors that predict locoregional recurrence or distant metastasis in patients with human papillomavirus (HPV)-positive oropharyngeal cancer treated with surgery and guideline-indicated adjuvant therapy.
We identified all presumed HPV-positive patients with oropharyngeal cancer in our health system from January 2010 to August 2012 treated with surgery and guideline-indicated adjuvant therapy. Statistical analysis was performed to identify clinical predictors associated with treatment failure.
One hundred fourteen p16+ oropharyngeal cancers managed with initial surgical resection were identified. Median follow-up was 17 months. Two-year locoregional failure was 3.3% and distant failure was 8.4%. Statistical analysis found that conventional poor prognostic features did not predict treatment failure.
Locoregional recurrence and development of distant metastatic disease are uncommon in patients who are appropriately selected for surgical management of p16+ oropharyngeal cancer regardless of the presence or absence of conventional poor prognostic features.
本研究旨在确定在接受手术及指南推荐辅助治疗的人乳头瘤病毒（HPV）阳性口咽癌患者中，预测局部区域复发或远处转移的临床因素。
我们在我们的医疗系统中识别出2010年1月至2012年8月期间所有接受手术及指南推荐辅助治疗的疑似HPV阳性口咽癌患者。进行统计分析以识别与治疗失败相关的临床预测因素。
共识别出114例接受初始手术切除的p16+口咽癌患者。中位随访时间为17个月。两年局部区域失败率为3.3%，远处失败率为8.4%。统计分析发现，传统的不良预后特征并不能预测治疗失败。
无论是否存在传统的不良预后特征，对于经适当选择接受p16+口咽癌手术治疗的患者，局部区域复发和远处转移性疾病的发生并不常见。
