5306 - Real-world data of clinicopathologic characteristics of young oropharyngeal cancer patients.

Background

The etiologic role of human papillomavirus (HPV) in oropharyngeal cancer (OPC) is well established and it explains the increase of young patients (pts) affected with OPC. This is an observational study representing a real-world experience evaluating clinicopathologic features and prognosis in young (<45 years old) OPC pts compared with older ones (≥45).

Methods

We conducted a retrospective cohort study of pts diagnosed with OPC in four Catalonian hospitals from 1991 to 2017. Data was collected from medical records. Unconditional logistic regression was used to compare age groups and Proportional hazards model (Cox regression) and Cumulative Incident Function (CIF) to analyze OPC-specific survival (OPC-sS) in locally advanced cases.

Results

A total of 865 pts were included, 49 in the young group (median age 42; range 28.5-45.0) and 816 in the old group (median age 61; range 45.1-93.9). There were no differences between age groups in terms of sex, anatomic subsite, toxic habits, HPV status (positivity defined as double p16/DNA positivity) or stage at diagnosis. There were more non-smokers HPV-related (HPV+) OPC pts than HPV-negative (HPV-) ones (p-value <0.001) in both age groups. Median follow-up was 2.24 years (0-22). Trend test showed that HPV+ OPC in the young group increased with time period but the proportion of young pts decreased (p-values = 0.034 and 0.027, respectively). In terms OPC-sS women (HR 0.62, 95%CI 0.41-0.93) had better prognosis compared to men. In contrast, smoker and drinker pts had worse prognosis estimates (HR 1.68 [95%CI 1.13-2.51] and HR 1.77 [95%CI 1.26-2.48], respectively) compared to non-smoker and non-drinker pts. In the restricted analysis for the young pts these differences did not reach the significance. No differences in the OPC-sS were observed by age group (HR 0.78 [95%CI 0.49-1.25]). CIF showed better OPC-sS in HPV+ OPC pts compared to HPV- ones, independently of the age. No differences by age were observed in the restricted analysis for HPV+ OPC pts. Nevertheless, none of the young HPV+ OPC pts died in the follow-up compared with a 16.4% of cancer-related deaths in the HPV+ old group.

Conclusions

HPV is the most important prognostic factor in OPC independent of age.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

ICO (Catalan Institute of Oncology).

Funding

The Instituto de Salud Carlos III-ISCIII (Spanish Government) co funded by EDER funds/ European Regional Development Fund (ERDF) - a way to build Europe (References: PI1102096, PI1401918, PI1500500, PI1501205, RD12/0036/0056, CIBERESP, CIBERONC).

Disclosure

M. Nieva: Travel / Accommodation / Expenses: Takeda; Travel / Accommodation / Expenses: Merck. S. Tous: Research grant / Funding (institution), Cancer Epidemiology Research Program (ST LA MM) has received sponsorship for grants from Merck and co, Seegene and GSK.: GSK; Research grant / Funding (institution), Cancer Epidemiology Research Program (ST LA MM) has received sponsorship for grants from Merck and co, Seegene and GSK.: Seegene; Research grant / Funding (institution), Cancer Epidemiology Research Program (ST LA MM) has received sponsorship for grants from Merck and co, Seegene and GSK.: Merck. M. Mena: Research grant / Funding (institution), Cancer Epidemiology Research Program (ST LA MM) has received sponsorship for grants from Merck and co, Seegene and GSK: GSK; Research grant / Funding (institution), Cancer Epidemiology Research Program (ST LA MM) has received sponsorship for grants from Merck and co, Seegene and GSK: Merck; Research grant / Funding (institution), Cancer Epidemiology Research Program (ST LA MM) has received sponsorship for grants from Merck and co, Seegene and GSK: Seegene. R. Mesia Nin: Advisory / Consultancy, Speaker Bureau / Expert testimony: Merck; Advisory / Consultancy, Speaker Bureau / Expert testimony: BMS; Advisory / Consultancy, Speaker Bureau / Expert testimony: MSD; Advisory / Consultancy: AZ; Advisory / Consultancy: Roche; Advisory / Consultancy: Nanobiotix. L. Alemany: Research grant / Funding (institution), Cancer Epidemiology Research Program (ST LA MM) has received sponsorship for grants from Merck and co, Seegene and GSK: GSK; Research grant / Funding (institution), Cancer Epidemiology Research Program (ST LA MM) has received sponsorship for grants from Merck and co, Seegene and GSK: Seegene; Research grant / Funding (institution), Cancer Epidemiology Research Program (ST LA MM) has received sponsorship for grants from Merck and co, Seegene and GSK: Merck. M. Taberna: Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Merck; Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: AZ; Advisory / Consultancy: Nanobiotics; Speaker Bureau / Expert testimony: MSD; Speaker Bureau / Expert testimony: Bristol Myers. All other authors have declared no conflicts of interest.