PMID- 31174105
OWN - NLM
STAT- MEDLINE
DCOM- 20200512
LR  - 20200518
IS  - 1879-0887 (Electronic)
IS  - 0167-8140 (Linking)
VI  - 140
DP  - 2019 Nov
TI  - Locally advanced hypopharyngeal and laryngeal cancer: Influence of HPV status.
PG  - 6-9
LID - S0167-8140(19)32914-7 [pii]
LID - 10.1016/j.radonc.2019.05.013 [doi]
AB  - BACKGROUND: Larynx preservation with chemoradiotherapy (CRT) is used frequently 
      in the treatment of locally advanced hypopharyngeal/laryngeal squamous cell 
      carcinoma (LSCC). Multiple large retrospective analyses have shown that CRT is 
      associated with worse overall survival (OS) compared to total laryngectomy (TL) 
      in patients with T4a disease. Burgeoning evidence suggests HPV status may play a 
      prognostic role in patients with LSCC. We aimed to determine if HPV status 
      influences OS among patients with T4a LSCC, and, if so, if it may be useful in 
      selecting patients for CRT. METHODS: Using the National Cancer Database (NCDB), 
      we identified 810 patients with T4a N0-3 M0 squamous cell carcinoma of the larynx 
      or hypopharynx with known HPV status who received either definitive CRT (to 
      66-81.6 Gy with any chemotherapy) or definitive TL (with the addition of 60-70 Gy 
      of adjuvant RT). We evaluated differences in OS using the Kaplan-Meier method and 
      Cox proportional hazards analyses. RESULTS: On multivariate analysis, 
      HPV-negative status (HR = 1.42, p = 0.02) and receipt of CRT (HR = 1.34, 
      p = 0.01) were associated with worse OS when compared to HPV-positive patients 
      and patients receiving TL, respectively. Among patients receiving CRT, 5-year OS 
      was lower among HPV-negative patients (33.4%) when compared to HPV-positive 
      patients (50.6%). CONCLUSIONS: These data suggest that HPV status may be a 
      prognostic factor in patients with T4a LSCC. Further, it supports further 
      investigation into the usefulness of HPV status as a selection factor for larynx 
      preservation with CRT in these patients.
CI  - Copyright (c) 2019 Elsevier B.V. All rights reserved.
FAU - Bates, James E
AU  - Bates JE
AD  - Departments of Radiation Oncology, University of Florida, Gainesville, United 
      States. Electronic address: bateja@shands.ufl.edu.
FAU - Morris, Christopher G
AU  - Morris CG
AD  - Departments of Radiation Oncology, University of Florida, Gainesville, United 
      States.
FAU - Hitchcock, Kathryn E
AU  - Hitchcock KE
AD  - Departments of Radiation Oncology, University of Florida, Gainesville, United 
      States.
FAU - Dziegielewski, Peter T
AU  - Dziegielewski PT
AD  - Departments of Otolaryngology, University of Florida, Gainesville, United States.
FAU - Mendenhall, William M
AU  - Mendenhall WM
AD  - Departments of Radiation Oncology, University of Florida, Gainesville, United 
      States.
FAU - Amdur, Robert J
AU  - Amdur RJ
AD  - Departments of Radiation Oncology, University of Florida, Gainesville, United 
      States.
LA  - eng
PT  - Journal Article
DEP - 20190604
PL  - Ireland
TA  - Radiother Oncol
JT  - Radiotherapy and oncology : journal of the European Society for Therapeutic 
      Radiology and Oncology
JID - 8407192
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Chemoradiotherapy
MH  - Female
MH  - Humans
MH  - Hypopharyngeal Neoplasms/mortality/therapy/*virology
MH  - Laryngeal Neoplasms/mortality/therapy/*virology
MH  - Male
MH  - Middle Aged
MH  - Papillomaviridae/*isolation & purification
MH  - Prognosis
MH  - Retrospective Studies
MH  - Squamous Cell Carcinoma of Head and Neck/mortality/therapy/*virology
OTO - NOTNLM
OT  - HPV
OT  - Head and neck
OT  - Human papilloma virus
OT  - National cancer data base
EDAT- 2019/06/08 06:00
MHDA- 2020/05/19 06:00
CRDT- 2019/06/08 06:00
PHST- 2019/02/13 00:00 [received]
PHST- 2019/05/09 00:00 [revised]
PHST- 2019/05/11 00:00 [accepted]
PHST- 2019/06/08 06:00 [pubmed]
PHST- 2020/05/19 06:00 [medline]
PHST- 2019/06/08 06:00 [entrez]
AID - S0167-8140(19)32914-7 [pii]
AID - 10.1016/j.radonc.2019.05.013 [doi]
PST - ppublish
SO  - Radiother Oncol. 2019 Nov;140:6-9. doi: 10.1016/j.radonc.2019.05.013. Epub 2019 
      Jun 4.