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- Title
Epidemiological and treatment-related factors contribute to improved outcome of oropharyngeal squamous cell carcinoma in Finland.
- Authors
Jouhi, Lauri; Halme, Elina; Irjala, Heikki; Saarilahti, Kauko; Koivunen, Petri; Pukkila, Matti; Hagström, Jaana; Haglund, Caj; Lindholm, Paula; Hirvikoski, Pasi; Vaittinen, Samuli; Ellonen, Anna; Tikanto, Jukka; Blomster, Henry; Laranne, Jussi; Grénman, Reidar; Mäkitie, Antti; Atula, Timo
- Abstract
Background: Treatment for oropharyngeal squamous cell carcinoma (OPSCC) has changed, as the proportion of human papilloma virus (HPV)-related disease has increased. We evaluated nationwide information on its management and outcome during the treatment paradigm change period. Methods: We included all patients diagnosed and treated for OPSCC at the five Finnish university hospitals from 2000 to 2009. Patient records and pathology registries provided the clinicopathological data. p16 staining was performed on primary tumor samples of patients who had received treatment with curative intent. Results: A total of 674 patients were diagnosed and treated for OPSCC and the incidence increased along the study period. Of the evaluable tumors 58.5% were p16-positive and the number of p16-positive tumors increased along the years. The treatment was given with curative intent for 600 patients and it was completed in 564. Of them, 47.9% underwent primary surgery and 52.1% received definitive oncological treatment. Also, the treatment protocol changed towards a more oncological approach. Among patients treated with curative intent the five-year overall, disease-specific and disease-free survival rates were 60.1, 71.5 and 57.0%. In multivariate analysis, p16-positivity seemed to relate to reduced disease mortality in lateral and anterior-wall disease. Depending on primary tumor localization, also sex, classes T3-4, presence of regional metastasis and radiotherapy modality had an association with disease mortality. Conclusion: The incidence of p16-positive OPSCC and delivery of definitive oncological treatment increased in Finland during the study period. An improved survival outcome compared with the previous nationwide investigation was observed in this subset of patients.
- Subjects
FINLAND; MORTALITY prevention; ACADEMIC medical centers; ONCOLOGIC surgery; METASTASIS; MORTALITY; MULTIVARIATE analysis; RADIOTHERAPY; SQUAMOUS cell carcinoma; STAINS &; staining (Microscopy); TREATMENT effectiveness; OROPHARYNGEAL cancer; PROGNOSIS; CANCER treatment
- Publication
Acta Oncologica, 2018, Vol 57, Issue 4, p541
- ISSN
0284-186X
- Publication type
Article
- DOI
10.1080/0284186X.2017.1400688