Department of Radiation Oncology, Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Department of Medical Oncology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China.
Front Public Health. 2022 Jul 25;10:900294. doi: 10.3389/fpubh.2022.900294. eCollection 2022.
To explore the effect of human papillomavirus (HPV) status on prognosis and further investigate whether human papillomavirus (HPV) status has an impact on the local treatment strategies for T1-2N0 oropharyngeal squamous cell cancer (OPSCC) patients.
Patients diagnosed with T1-2N0 OPSCC between 2010 and 2015 were included from the Surveillance, Epidemiology, and End Results database. Data were analyzed using propensity score matching (PSM), Chi-square test, Kaplan-Meier survival analysis, and Cox multivariable analyses.
A total of 1,004 patients were identified, of whom 595 (59.3%) had HPV-related tumors. Of all the patients, 386 (38.4%) and 618 (61.6%) received definitive radiotherapy and radical surgery, respectively. HPV status had no significant effect on local treatment strategies for early-stage OPSCC ( = 0.817). The 3-year cancer-specific survival (CSS) and overall survival (OS) were 89.6 and 80.1%, respectively. Compared to those with HPV-negative diseases, patients with HPV-positive diseases had better CSS and OS. A total of 222 pairs of patients were completely matched after PSM. The results of multivariate Cox regression analysis showed that patients with HPV-positive disease had significantly better CSS ( = 0.001) and OS ( < 0.001) compared to those with HPV-negative tumors. However, local treatment strategy was not associated with survival outcomes after PSM (CSS, = 0.771; OS, = 0.440). The subgroup analysis showed comparable CSS and OS between those treated with radical surgery and definitive radiotherapy regardless of HPV status.
HPV status is an independent prognostic factor for the survival of stage T1-2N0 OPSCC patients. Local treatment strategies had no significant effect on the survival of early-stage OPSCC regardless of HPV status. Patients with early-stage OPSCC should be informed regarding the pros and cons of definitive radiotherapy or radical surgery.
探讨人乳头瘤病毒（HPV）状态对预后的影响，并进一步研究 HPV 状态是否对 T1-2N0 口咽鳞状细胞癌（OPSCC）患者的局部治疗策略有影响。
从监测、流行病学和最终结果（SEER）数据库中纳入 2010 年至 2015 年间诊断为 T1-2N0 OPSCC 的患者。采用倾向评分匹配（PSM）、卡方检验、Kaplan-Meier 生存分析和 Cox 多变量分析对数据进行分析。
共纳入 1004 例患者，其中 595 例（59.3%）为 HPV 相关肿瘤。所有患者中，分别有 386 例（38.4%）和 618 例（61.6%）接受了根治性放疗和根治性手术。HPV 状态对早期 OPSCC 的局部治疗策略无显著影响（=0.817）。3 年癌症特异性生存率（CSS）和总生存率（OS）分别为 89.6%和 80.1%。与 HPV 阴性疾病患者相比，HPV 阳性疾病患者的 CSS 和 OS 更好。PSM 后共匹配 222 对患者。多变量 Cox 回归分析结果显示，HPV 阳性疾病患者的 CSS（=0.001）和 OS（<0.001）明显优于 HPV 阴性肿瘤患者。然而，PSM 后局部治疗策略与生存结局无关（CSS，=0.771；OS，=0.440）。亚组分析显示，无论 HPV 状态如何，接受根治性手术和根治性放疗的患者的 CSS 和 OS 相当。
HPV 状态是 T1-2N0 OPSCC 患者生存的独立预后因素。局部治疗策略对 HPV 状态无关的早期 OPSCC 患者的生存无显著影响。早期 OPSCC 患者应了解根治性放疗或根治性手术的利弊。
