Pathology-based staging for HPV-positive squamous carcinoma of the oropharynx.
Pathology-based staging for HPV-positive squamous carcinoma of the oropharynx.
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DOI：
10.1016/j.oraloncology.2016.09.004
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发表时间：
2016-11
期刊：
影响因子：
4.8
通讯作者：
Lydiatt WM
中科院分区：
文献类型：
--
作者：
Haughey BH;Sinha P;Kallogjeri D;Goldberg RL;Lewis JS Jr;Piccirillo JF;Jackson RS;Moore EJ;Brandwein-Gensler M;Magnuson SJ;Carroll WR;Jones TM;Wilkie MD;Lau A;Upile NS;Sheard J;Lancaster J;Tandon S;Robinson M;Husband D;Ganly I;Shah JP;Brizel DM;O'Sullivan B;Ridge JA;Lydiatt WM
人乳头瘤病毒（HPV）阳性口咽鳞状细胞癌（OPSCC）的发病率在全球范围内迅速上升，研究证实这种疾病是一种不同于传统OPSCC的疾病。基于病理学，手术研究揭示了HPV阳性OPSCC的特异性促癌因子。目前AJCC/UICC分期和病理淋巴结（pN）分类不能区分生存期，表明需要新的HPV特异性OPSCC分期。本研究的目的是确定HPV阳性OPSCC的病理分期系统。数据收集自5个癌症中心的704名患者的p16阳性OPSCC队列（任何T，任何N，M0）。分析了a）AJCC/UICC病理分期，B）新发表的非手术治疗HPV阳性OPSCC的临床分期，以及c）一种新的基于病理学的“HPV路径”分期系统，该系统结合了原发肿瘤和淋巴结转移的特征。AJCC/UICC PT分类和病理学证实的转移性淋巴结计数（<4 vs ≥5）的组合产生了三组，I期（pT 1-T2，≤ 4个淋巴结）、II期（pT 1-T2，≥ 5个淋巴结; pT 3-T4，≤ 4个淋巴结）和III期（pT 3-T4，≥ 5个淋巴结），预后逐渐变差（Kaplan-Meier总生存率分别为90%、84%和48%）。现有的AJCC/UICC病理分期缺乏预后定义。新发表的非手术治疗患者的HPV特异性临床分期，尽管具有预后性，但显示手术治疗队列的精确度较低。基于AJCC/UICC原发肿瘤PT分类和转移性淋巴结计数的组合，HPV阳性OPSCC可识别三个局部区域“HPV路径”阶段。一个可行的病理分期系统是可行的，以指导预后和辅助治疗的决定，在外科治疗HPV阳性OPSCC。
The rapid worldwide rise in incidence of human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) has generated studies confirming this disease as an entity distinct from traditional OPSCC. Based on pathology, surgical studies have revealed prognosticators specific to HPV-positive OPSCC. The current AJCC/UICC staging and pathologic nodal (pN)-classification do not differentiate for survival, demonstrating the need for new, HPV-specific OPSCC staging. The objective of this study was to define a pathologic staging system specific to HPV-positive OPSCC. Data were assembled from a surgically-managed, p16-positive OPSCC cohort (any T, any N, M0) of 704 patients from five cancer centers. Analysis was performed for a) the AJCC/UICC pathologic staging, b) newly published clinical staging for non-surgically managed HPV-positive OPSCC and c), a novel, pathology-based, “HPVpath” staging system that combines features of the primary tumor and nodal metastases. A combination of AJCC/UICC pT-classification and pathology-confirmed metastatic node count (<4 versus ≥5) yielded three groups, stages I (pT1-T2, ≤ 4 nodes), II (pT1-T2, ≥ 5 nodes; pT3-T4, ≤ 4 nodes), and III (pT3-T4, ≥ 5 nodes), with incrementally worse prognosis (Kaplan-Meier overall survival of 90%, 84% and 48% respectively). Existing AJCC/UICC pathologic staging lacked prognostic definition. Newly published HPV-specific clinical stagings from non-surgically managed patients, although prognostic, showed lower precision for this surgically managed cohort. Three loco-regional “HPVpath” stages are identifiable for HPV-positive OPSCC, based on a combination of AJCC/UICC primary tumor pT-classification and metastatic node count. A workable, pathologic staging system is feasible to guide prognosis and adjuvant therapy decisions in surgically-managed HPV-positive OPSCC.
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影响因子：
2.6
作者：
Grant, David G.;Salassa, John R.;Perry, William C.
通讯作者：
Perry, William C.
影响因子：
--
作者：
Koch, Wayne M.;Ridge, John A.;Manola, Judith
通讯作者：
Manola, Judith
DOI：
10.6004/jnccn.2015.0102
发表时间：
2015-07
期刊：
Journal of the National Comprehensive Cancer Network : JNCCN
影响因子：
--
作者：
Pfister DG;Spencer S;Brizel DM;Burtness B;Busse PM;Caudell JJ;Cmelak AJ;Colevas AD;Dunphy F;Eisele DW;Foote RL;Gilbert J;Gillison ML;Haddad RI;Haughey BH;Hicks WL Jr;Hitchcock YJ;Jimeno A;Kies MS;Lydiatt WM;Maghami E;McCaffrey T;Mell LK;Mittal BB;Pinto HA;Ridge JA;Rodriguez CP;Samant S;Shah JP;Weber RS;Wolf GT;Worden F;Yom SS;McMillian N;Hughes M
通讯作者：
Hughes M
影响因子：
6.2
作者：
Sinha, Parul;Lewis, James S., Jr.;Haughey, Bruce H.
通讯作者：
Haughey, Bruce H.
影响因子：
2.6
作者：
Haughey, Bruce H.;Sinha, Parul
通讯作者：
Sinha, Parul