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DOI: 10.1055/s-0041-1727971
Risk stratification in HPV-associated oropharyngeal squamous cell carcinoma – development and validation of a new risk stratification system
Introduction Risk stratification for HPV OPSCC in 8thedition AJCC/UICC staging manual isn’t sufficient enough in certain subgroups. Therefore we developed a risk stratification system by taking into account important risc factors in OPSCC like smoking (>10py), intensive alcohol abuse (>3 days/week) and gender beside HPV and TNM status.
Methods 464 patients with treated OPSCC between 2001 and 2017 at our ENT University Hospital Muenster were included in this study. The cohort was randomized with an allocation ratio of 2:1 into a training set (n=294) and a validation set (n=190). On basis of multivariable Cox regression analysis of nontherapy parameters (gender, HPV- , smoking- , alcohol status, T and N stage 8thedition UICC) a risk score (RS; range: 0 to 4.5) was built. Four risk groups were defined on optimal stratification of the RS in which every patient was classified regarding their individual risk score. Overall survival rates of the risk groups were compared with Kaplan-Meier method (Log Rank test, p<0,005).
Results 228 patients (49,1 % ) were HPV positive (HPV E6/E7 DNA). In our preferred upfront surgery cohort (66 % ) we saw a significant difference between risk groups concerning 5-year overall survival in log rank test (p=0,001). The validation set showed similar results (p=0,036).
Discussion Our risk stratification system underlines that smoking (>10py), alcohol (>3 days/week) and gender can improve risc stratification in HPV associated OPSCC. Therefore we recommend to put emphasize on these factors in future tumor classifications beside HPV and TNM status.
Poster-PDF A-1370.pdf
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Conflict of interest
Der Erstautor gibt keinen Interessenskonflikt an.
Address for correspondence
Publikationsverlauf
Artikel online veröffentlicht:
13. Mai 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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