Optimization of therapeutic strategy for p16-positive oropharyngeal squamous cell carcinoma: Multi-institutional observational study based on the national Head and Neck Cancer Registry of Japan

Yuki Saito, Ryuichi Hayashi, Yoshiyuki Iida, Takatsugu Mizumachi, Takashi Fujii, Fumihiko Matsumoto, Takeshi Beppu, Masafumi Yoshida, Hirotaka Shinomiya, Ryosuke Kamiyama, Mutsukazu Kitano, Kazuhiko Yokoshima, Yasushi Fujimoto, Takanori Hama, Taku Yamashita, Kenji Okami, Kouki Miura, Takuo Fujisawa, Daisuke Sano, Hisayuki KatoShujiro Minami, Masashi Sugasawa, Muneyuki Masuda, Ichiro Ota, Shigemichi Iwae, Ryo Kawata, Nobuya Monden, Takayuki Imai, Takahiro Asakage, Masafumi Okada, Takanori Yoshikawa, Kensuke Tanioka, Megumi Kitayama, Mariko Doi, Satoshi Fujii, Masato Fujii, Nobuhiko Oridate, Munenaga Nakamizo, Seiichi Yoshimoto, Akihiro Homma, Ken ichi Nibu, Katsunari Yane

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Although the American Joint Committee on Cancer TNM classification has been amended to include human papillomavirus (HPV)–related oropharyngeal squamous cell carcinoma (OPSCC) as an independent entity, to the authors' knowledge the optimized de-escalating treatment modality has not been established to date. Methods: The authors conducted a retrospective, nationwide, observational study in patients with HPV-related OPSCC who were treated from 2011 to 2014 in Japan to determine the best treatment modality. Results: A total of 688 patients who were newly diagnosed with HPV-related OPSCC who were treated with curative intent at 35 institutions and had coherent clinical information and follow-up data available were included in the current study. In patients with T1-T2N0 disease (79 patients), both the 3-year recurrence-free survival and overall survival (OS) rates were 100% in the group treated with radiotherapy (RT) as well as the group receiving concurrent chemoradiotherapy (CCRT). The 3-year OS rates were 94.4% (for patients with T1N0 disease) and 92.9% (for patients with T2N0 disease) among the patients treated with upfront surgery. In patients with stage I to stage II HPV-related OPSCC, the 5-year recurrence-free survival and OS rates were 91.4% and 92%, respectively, in the patients treated with CCRT with relatively high-dose cisplatin (≥160 mg/m2; 114 patients) and 74.3% and 69.5%, respectively, in the patients treated with low-dose cisplatin (<160 mg/m2; 17 patients). Conclusions: Despite it being a retrospective observational trial with a lack of information regarding toxicity and morbidity, the results of the current study demonstrated that patients with T1-T2N0 HPV-related OPSCC could be treated with RT alone because of the equivalent outcomes of RT and CCRT, and patients with stage I to stage II HPV-related OPSCC other than those with T1-T2N0 disease could be treated with CCRT with cisplatin at a dose of ≥160 mg/m2.

Original languageEnglish
Pages (from-to)4177-4187
Number of pages11
JournalCancer
Volume126
Issue number18
DOIs
Publication statusPublished - 15-09-2020

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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