1045P - Outcome of oropharyngeal cancer according to treatment in different risk-profile groups: analysis of a retrospective series of patients treated in a...

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Cancer Aetiology, Epidemiology, Prevention
Head and Neck Cancers
Presenter Paolo Bossi
Authors P. Bossi1, R. Granata1, E. Orlandi2, F. Perrone3, L. Locati4, C. Fallai2, S. Pilotti5, L. Ferraro6, G. Scaramellini6, L. Licitra1
  • 1Oncologia Medica, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 - Milano/IT
  • 2Radiation Oncology, Fondazione IRCCS Istituto Nazionale Tumori Milano, 20133 - Milano/IT
  • 3Pathology Department, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milano,, 20133 - Milano/IT
  • 4Head & Neck Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 - Milano/IT
  • 5Pathology And Molecular Biology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano/IT
  • 6Otholaryngology - Head And Neck Surgery, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milano/IT

Abstract

Background

Epidemiology and outcome of oropharyngeal cancer (OPC) are changing in the last decades, due to the role of HPV infection. No different treatment modality has been identified as more effective in treating OPC according to HPV or smoking status.

Material and methods

Two series of locally advanced (stage III-IV) squamous cell OPC patients (pts) treated at our Institution were considered:

1) treated with surgery followed by radiotherapy (dose 50-66 Gy), from 1/1991 to 7/2000 (“surgical series”)

2) receiving concurrent chemoradiation (CTRT) (RT dose = 66-70 Gy), with/without induction docetaxel, cisplatin, 5-fluorouracil (TPF) chemotherapy (CT), from 7/2004 to 3/2011 (“CTRT series”)

Smoking habits and tumoral p16 expression were analyzed in order to stratify each series according to Ang risk profile (low, intermediate, high risk). Overall survival (OS) and disease free survival (DFS) were calculated with Kaplan-Meier method.

Results

Globally, 171 pts were considered, 56 in surgical and 115 in CTRT series. In CTRT series, 40% of the pts received induction TPF chemotherapy; in surgical series 57% of the pts had extracapsular extension and/or microscopically involved surgical margins.

Surgical series CTRT series
p16 expression 39% 59%
Stage III 13% 7%
Stage IV 87% 93%
Low risk 20% 20%
Intermediate risk 23% 41%
High risk 57% 39%

Five-year (yr) OS for p16 positive pts was 50% in surgical and 88% in CTRT series, while for p16 negative was 38% and 49% respectively (p < 0.0001).

When stratifying for risk profile, 5-yr OS of low risk CTRT pts was 100% vs 54% of surgical pts (p = 0.0042) and 5-yr DFS was 93% vs 53% (p = 0.0079); 5-yr OS of intermediate risk CTRT pts was 76% vs 46% of surgical pts (p = 0.0141) and 5-yr DFS was 79% vs 38% (p = 0.0359). High risk CTRT pts had a 5-yr OS of 51% vs 36% of surgical pts (p = 0.1902) and a 5-yr DFS of 24% vs 36% (p = 0.6411).

Discussion

In this retrospective analysis, low and intermediate risk OPC pts had a greater survival benefit when treated with CTRT compared with surgery followed by RT. Although with the limits of different RT techniques and lack of CT in adjunct to postoperative RT, these data should be considered as hypothesis generating for new trials design.

Disclosure

All authors have declared no conflicts of interest.