Optimization of therapeutic strategy for p16-positive oropharyngeal squamous cell carcinoma: Multi-institutional observational study based on the national Head and Neck Cancer Registry of Japan

Yuki Saito; Ryuichi Hayashi; Yoshiyuki Iida; Takatsugu Mizumachi; Takashi Fujii; Fumihiko Matsumoto; Takeshi Beppu; Masafumi Yoshida; Hirotaka Shinomiya; Ryosuke Kamiyama; Mutsukazu Kitano; Kazuhiko Yokoshima; Yasushi Fujimoto; Takanori Hama; Taku Yamashita; Kenji Okami; Kouki Miura; Takuo Fujisawa; Daisuke Sano; Hisayuki Kato; Shujiro Minami; Masashi Sugasawa; Muneyuki Masuda; Ichiro Ota; Shigemichi Iwae; Ryo Kawata; Nobuya Monden; Takayuki Imai; Takahiro Asakage; Masafumi Okada; Takanori Yoshikawa; Kensuke Tanioka; Megumi Kitayama; Mariko Doi; Satoshi Fujii; Masato Fujii; Nobuhiko Oridate; Munenaga Nakamizo; Seiichi Yoshimoto; Akihiro Homma; Ken-Ichi Nibu; Katsunari Yane

doi:10.1002/cncr.33062

Optimization of therapeutic strategy for p16-positive oropharyngeal squamous cell carcinoma: Multi-institutional observational study based on the national Head and Neck Cancer Registry of Japan

Cancer. 2020 Sep 15;126(18):4177-4187. doi: 10.1002/cncr.33062. Epub 2020 Jul 10.

Authors

Yuki Saito¹, Ryuichi Hayashi², Yoshiyuki Iida³, Takatsugu Mizumachi⁴, Takashi Fujii⁵, Fumihiko Matsumoto⁶, Takeshi Beppu⁷, Masafumi Yoshida¹, Hirotaka Shinomiya⁸, Ryosuke Kamiyama⁹, Mutsukazu Kitano¹⁰, Kazuhiko Yokoshima¹¹, Yasushi Fujimoto¹², Takanori Hama¹³, Taku Yamashita¹⁴, Kenji Okami¹⁵, Kouki Miura¹⁶, Takuo Fujisawa¹⁷, Daisuke Sano¹⁸, Hisayuki Kato¹⁹, Shujiro Minami²⁰, Masashi Sugasawa²¹, Muneyuki Masuda²², Ichiro Ota²³, Shigemichi Iwae²⁴, Ryo Kawata²⁵, Nobuya Monden²⁶, Takayuki Imai²⁷, Takahiro Asakage²⁸, Masafumi Okada²⁹, Takanori Yoshikawa³⁰, Kensuke Tanioka³¹, Megumi Kitayama³⁰, Mariko Doi³², Satoshi Fujii^{33

34}, Masato Fujii²⁰, Nobuhiko Oridate¹⁸, Munenaga Nakamizo¹¹, Seiichi Yoshimoto⁶, Akihiro Homma⁴, Ken-Ichi Nibu⁸, Katsunari Yane³⁵

Affiliations

¹ Department of Otolaryngology, Head and Neck Surgery, University of Tokyo, Tokyo, Japan.
² Department of Head and Neck Surgery, National Cancer Center Hospital East, Chiba, Japan.
³ Department of Head and Neck Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan.
⁴ Department of Otorhinolaryngology, Hokkaido University Hospital, Hokkaido, Japan.
⁵ Department of Head and Neck Surgery, Osaka International Cancer Institute, Osaka, Japan.
⁶ Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan.
⁷ Department of Head and Neck Surgery, Saitama Cancer Center, Saitama, Japan.
⁸ Department of Otolaryngology-Head and Neck Surgery, Kobe University School of Medicine, Hyogo, Japan.
⁹ Department of Head and Neck Surgery, Cancer Institute Hospital, Tokyo, Japan.
¹⁰ Department of Otolaryngology, Kindai University Faculty of Medicine, Osaka, Japan.
¹¹ Department of Otorhinolaryngology, Nippon Medical School Hospital, Tokyo, Japan.
¹² Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
¹³ Department of Otolaryngology, Jikei University Hospital, Tokyo, Japan.
¹⁴ Department of Otolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa, Japan.
¹⁵ Department of Otolaryngology, Tokai University Hospital, Kanagawa, Japan.
¹⁶ Department of Head and Neck Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
¹⁷ Department of Otolaryngology, Kansai Medical University, Osaka, Japan.
¹⁸ Department of Otolaryngology-Head and Neck Surgery, Yokohama City University, School of Medicine, Kanagawa, Japan.
¹⁹ Department of Otolaryngology & Head and Neck Surgery, Fujita Health University School of Medicine, Aichi, Japan.
²⁰ Department of Otolaryngology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
²¹ Department of Head and Neck Surgery, Saitama Medical University International Medical Center, Saitama, Japan.
²² Department of Head and Neck Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
²³ Department of Otolaryngology, Nara Medical University Hospital, Nara, Japan.
²⁴ Department of Head and Neck Surgery, Hyogo Cancer Center, Hyogo, Japan.
²⁵ Department of Otolaryngology, Osaka Medical College Hospital, Osaka, Japan.
²⁶ Department of Head and Neck Surgery, National Hospital Organization Shikoku Cancer Center, Ehime, Japan.
²⁷ Department of Head and Neck Surgery, Miyagi Cancer Center, Miyagi, Japan.
²⁸ Department of Head and Neck Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan.
²⁹ University Hospital Medical Information Network, Tokyo, Japan.
³⁰ Data Center Department, Clinical Study Support Center, Wakayama Medical University Hospital, Wakayama, Japan.
³¹ Faculty of life and biomedical sciences, Doshisha Univeristy, Kyoto, Japan.
³² Department of Health Policy and Technology Assessment, National Institute of Public Health, Saitama, Japan.
³³ Division of Pathology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center Hospital East, Chiba, Japan.
³⁴ Department of Molecular Pathology, Yokohama City University School of Medicine, Kanagawa, Japan.
³⁵ Department of Otorhinolaryngology, Kindai University Nara Hospital, Nara, Japan.

PMID: 32648953
DOI: 10.1002/cncr.33062

Abstract

Background: Although the American Joint Committee on Cancer TNM classification has been amended to include human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) as an independent entity, to the authors' knowledge the optimized de-escalating treatment modality has not been established to date.

Methods: The authors conducted a retrospective, nationwide, observational study in patients with HPV-related OPSCC who were treated from 2011 to 2014 in Japan to determine the best treatment modality.

Results: A total of 688 patients who were newly diagnosed with HPV-related OPSCC who were treated with curative intent at 35 institutions and had coherent clinical information and follow-up data available were included in the current study. In patients with T1-T2N0 disease (79 patients), both the 3-year recurrence-free survival and overall survival (OS) rates were 100% in the group treated with radiotherapy (RT) as well as the group receiving concurrent chemoradiotherapy (CCRT). The 3-year OS rates were 94.4% (for patients with T1N0 disease) and 92.9% (for patients with T2N0 disease) among the patients treated with upfront surgery. In patients with stage I to stage II HPV-related OPSCC, the 5-year recurrence-free survival and OS rates were 91.4% and 92%, respectively, in the patients treated with CCRT with relatively high-dose cisplatin (≥160 mg/m² ; 114 patients) and 74.3% and 69.5%, respectively, in the patients treated with low-dose cisplatin (<160 mg/m² ; 17 patients).

Conclusions: Despite it being a retrospective observational trial with a lack of information regarding toxicity and morbidity, the results of the current study demonstrated that patients with T1-T2N0 HPV-related OPSCC could be treated with RT alone because of the equivalent outcomes of RT and CCRT, and patients with stage I to stage II HPV-related OPSCC other than those with T1-T2N0 disease could be treated with CCRT with cisplatin at a dose of ≥160 mg/m² .

Keywords: Japan; head and neck squamous cell carcinoma (HNSCC); human papillomavirus (HPV); oropharyngeal carcinoma; p16.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell / mortality
Carcinoma, Squamous Cell / pathology
Carcinoma, Squamous Cell / therapy*
Female
Head and Neck Neoplasms / mortality
Head and Neck Neoplasms / pathology
Head and Neck Neoplasms / therapy*
Humans
Japan
Male
Middle Aged
Oropharyngeal Neoplasms / mortality
Oropharyngeal Neoplasms / pathology
Oropharyngeal Neoplasms / therapy*
Registries
Retrospective Studies
Survival Rate

Abstract

Publication types

MeSH terms

Grants and funding