Oropharyngeal cancer: First relapse description and prognostic factor of salvage treatment according to p16 status, a GETTEC multicentric study
Dorian Culié
(1)
,
Quentin Lisan
(2, 3)
,
Charlotte Leroy
(4)
,
Anouchka Modesto
(5)
,
Renaud Schiappa
(2, 3)
,
Emmanuel Chamorey
(2, 3)
,
Olivier Dassonville
(1)
,
Gilles Poissonnet
(1)
,
Bruno Guelfucci
(6)
,
Alain Bizeau
(6)
,
Sebastien Vergez
(5)
,
Agnes Dupret-Bories
(5)
,
Renaud Garrel
(7)
,
Nicolas Fakhry
(8)
,
Laure Santini
(8)
,
Benjamin Lallemant
(9)
,
Guillaume Chambon
(9)
,
Anne Sudaka
(1)
,
Frederic Peyrade
(1)
,
Esma Saada-Bouzid
(1)
,
Karen Benezery
(1)
,
Florence Jourdan-Soulier
(6)
,
Françoise Chapel
(6)
,
Anne Sophie Ramay
(9)
,
Pascal Roger
(9)
,
Thibault Galissier
(5)
,
Valérie Coste
(7)
,
Aicha Lakdar
(10)
,
Stephane Temam
(10, 11)
,
Phillipe Gorphe
(10, 11)
,
Joanne Guerlain
(10, 11)
,
Alexandre Bozec
(1)
,
Haitham Mirghani
(2)
1
UNICANCER/CAL -
Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
2 HEGP - Hôpital Européen Georges Pompidou [APHP]
3 PARCC (UMR_S 970/ U970) - Paris-Centre de Recherche Cardiovasculaire
4 Hôpital Lariboisière-Fernand-Widal [APHP]
5 IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole
6 Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer - Hôpital Sainte-Musse
7 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
8 Service d'Oto-rhino-laryngologie et Chirurgie cervico-faciale [Hôpital de la Conception - APHM]
9 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
10 IGR - Institut Gustave Roussy
11 CCF - Département de cancérologie cervico-faciale [Gustave Roussy]
2 HEGP - Hôpital Européen Georges Pompidou [APHP]
3 PARCC (UMR_S 970/ U970) - Paris-Centre de Recherche Cardiovasculaire
4 Hôpital Lariboisière-Fernand-Widal [APHP]
5 IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole
6 Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer - Hôpital Sainte-Musse
7 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
8 Service d'Oto-rhino-laryngologie et Chirurgie cervico-faciale [Hôpital de la Conception - APHM]
9 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
10 IGR - Institut Gustave Roussy
11 CCF - Département de cancérologie cervico-faciale [Gustave Roussy]
Anouchka Modesto
- Function : Author
- PersonId : 767322
- ORCID : 0000-0003-2133-6454
Renaud Schiappa
- Function : Author
- PersonId : 764122
- ORCID : 0000-0001-5104-9507
Emmanuel Chamorey
- Function : Author
- PersonId : 760333
- ORCID : 0000-0002-6841-4571
Gilles Poissonnet
- Function : Author
- PersonId : 761954
- ORCID : 0000-0002-9022-4352
Alain Bizeau
- Function : Author
- PersonId : 800053
- ORCID : 0000-0001-6757-4330
Agnes Dupret-Bories
- Function : Author
- PersonId : 1246074
- IdHAL : agnes-dupret-bories
- ORCID : 0000-0002-7068-3500
- IdRef : 147322693
Anne Sudaka
- Function : Author
- PersonId : 760281
- ORCID : 0000-0001-5729-0465
Phillipe Gorphe
- Function : Author
- PersonId : 765983
- ORCID : 0000-0001-7604-4964
Alexandre Bozec
- Function : Author
- PersonId : 760282
- ORCID : 0000-0002-8576-3052
- IdRef : 095272577
Abstract
Although Human Papilloma Virus (HPV)-driven oropharyngeal cancer (OPC) prognosis is significantly better than that of other head and neck cancers, up to 25% of cases will recur within 5 years. Data on the pattern of disease recurrence and efficiency of salvage treatment are still sparse.
Material and method: Observational study of all recurrent OPCs diagnosed, following a curative intent treatment, in seven French centers from 2009 to 2014. p16 Immunohistochemistry was used to determine HPV status. Clinical characteristics, distribution of recurrence site, and treatment modalities were compared by HPV tumor status. Overall survival was examined using Kaplan-Meier and multivariate Cox regression modeling.
Results: 350 recurrent OPC patients (246 p16-negative and 104 p16-positive patients). The site of recurrence was more frequently locoregional for p16-negative patients (65.4% versus 52.9% in p16-positive patients) and metastatic for p16-positive patients (47.1% versus 34.6% in p16-patients, p = 0.03). Time from diagnosis to recurrence did not differ between p16-positive and p16-negative patients (12 and 9.6 months, respectively, p-value = 0.2), as the main site of distant metastasis (all p-values ≥0.10). Overall and relapse-free survival following the first recurrence did not differ according to p16 status (p-values from log-rank 0.30 and 0.40, respectively). In multivariate analysis, prognosis factors for overall survival in p16-negative patients were distant metastasis (HR 2.11, 95% CI 1.30-3.43) and concurrent local and regional recurrences (HR 2.20, 95% CI 1.24-3.88).
Conclusion: With the exception of the initial site of recurrence, the pattern of disease relapse and the efficiency of salvage treatment are not different between p16-positive and negative OPCs.