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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

3940 - Validation of the Clinical AJCC/UICC TNM 8th Edition for Human Papillomvirus Related Oropharyngeal Squamous Cell Carcinoma

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Presenters

Sarah Deschuymer

Citation

Annals of Oncology (2018) 29 (suppl_8): viii372-viii399. 10.1093/annonc/mdy287

Authors

S. Deschuymer1, R. Dok2, A. Laenen3, E. Hauben4, S. Nuyts1

Author affiliations

  • 1 Department Of Radiation oncology, KU Leuven - University Hospitals Leuven, 3000 - Leuven/BE
  • 2 Laboratory Of Experimental Radiotherapy - Department Of Oncology, KU Leuven - University of Leuven, 3000 - Leuven/BE
  • 3 Leuven Biostatistics And Statistical Bioinformatics Centre (l-biostat), KU Leuven University, 3000 - Leuven/BE
  • 4 Department Of Imaging And Pathology, University Hospitals Leuven, Leuven/BE
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Resources

Abstract 3940

Background

With the growing interest in treatment de-intensification trials for human papillomavirus positive (HPV+) oropharyngeal squamous cell carcinoma (OPC), accurate patient stratification has become essential for patient selection. The aim of this study was to validate the prognostic ability of the AJCC/UICC TNM 8th edition (8th Ed) for HPV+ OPC.

Methods

Patients with HPV+ OPC treated with curative (chemo)radiotherapy ((C)RT) between 2004 and 2017 were classified according to the TNM 7th edition (7th Ed) and the new clinical TNM 8th Ed. HPV status was determined by p16 immunohistochemistry staining. The 5-year overall survival (5YOS) was estimated using the Kaplan-Meier method and groups were compared using the log-rank test. Harrell’s C-index was used as measure of model performance.

Results

A total of 333 OPC were identified of whom 100 were HPV+. The median follow-up was 63.7 months (IQR 30.0;99.9). The 5Y-OS with the 7th Ed were stage I/II 88.9% (CI95% 43.3;98.4), stage III 70.0% (CI95% 22.5;91.8), stage IVa 71.4% (CI95% 57.3;81.6) and stage IVb 29.8% (1.4;71.1) (p = 0.38). With the TNM 8th Ed, the 5Y-OS of stage I, II and III were 91.6% (CI95% 76.1;97.2), 55.2% (CI95% 29.2;75.1) and 38.0% (CI95% 8.7;68.2) (p = 0.006). On Cox regression analysis, when compared to stage I, OS was significantly lower for stage II (p = 0.018, Hazard ratio (HR)= 4.24 (CI95% 1.27;14.13)) and for stage III (p = 0.004, HR = 5.40 (CI95% 1.69;17.26)). Nevertheless, there was no significant difference between stage II and III (p = 0.60, HR = 1.27 (CI95% 0.51;3.17)). The Harrell’s C-index for TNM 8th Ed stage was 0.67.

Conclusions

Although the TNM 8th Ed provides better OS stratification than the 7th Ed for HPV+ OPC following (C)RT, better prognostic models are needed due to the lack of differentiation between stage II and stage III. This study emphasizes the importance of further research in patient selection and personalized treatment for HPV+ OPC.

Clinical trial identification

Legal entity responsible for the study

The ethics committee of the University Hospitals of Leuven.

Funding

Grant from Stand up to Cancer (Kom op tegen kanker), the Flemish cancer society.

Editorial Acknowledgement

Disclosure

S. Deschuymer: Grant: Stand up to Cancer (Kom op tegen kanker), the Flemish cancer society. All other authors have declared no conflicts of interest.

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