Tobacco exposure as a major modifier of oncologic outcomes in human papillomavirus (HPV) associated oropharyngeal squamous cell carcinoma.
Tobacco exposure as a major modifier of oncologic outcomes in human papillomavirus (HPV) associated oropharyngeal squamous cell carcinoma.
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DOI：
10.1186/s12885-020-07427-7
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发表时间：
2020-09-23
期刊：
影响因子：
3.8
通讯作者：
Sandulache VC
中科院分区：
文献类型：
--
作者：
Elhalawani H;Mohamed ASR;Elgohari B;Lin TA;Sikora AG;Lai SY;Abusaif A;Phan J;Morrison WH;Gunn GB;Rosenthal DI;Garden AS;Fuller CD;Sandulache VC
在美国，口咽鳞状细胞癌（OPSCC）的发病率正在迅速增加，主要是由人乳头瘤病毒（HPV）介导的OPSCC的流行所驱动的。虽然HPV介导的OPSCC （HPV+ OPSCC）患者的生存率通常优于非病毒介导的OPSCC患者，但这种效果并不均匀。我们假设烟草暴露仍然是HPV+ OPSCC患者生存的关键修饰因素。我们对2002-2013年在同一研究所接受p16和HPV检测的611例OPSCC患者进行了回顾性分析。生存率分析采用Kaplan-Meier分析和Cox回归。采用递归划分分析（RPA）确定烟草暴露与生存的关系（p < 0.05）。单因素和多因素分析显示，烟草暴露影响HPV+患者的总生存期（OS） （p = 0.002, p = 0.003）。RPA确定30包年（PY）是HPV+患者生存显著恶化的阈值。HPV+ bbb30 PY患者的OS和无病生存期（DFS）与HPV- PY患者无显著差异（p = 0.72, p = 0.27）。HPV+ bbb30 PY患者与≤30 PY患者相比，5年OS显著降低：78.4% vs 91.6%；P = 0.03, 76% vs 88.3%；P = 0.07, 52.3% vs 74%；p = 0.05，分别为阶段I， II和III （AJCC第8版手册）。烟草暴露可以消除与OPSCC患者HPV+状态相关的生存益处。在使用前瞻性数据集明确量化这种影响之前，应避免降低对HPV + OPSCC吸烟者的治疗升级。
The incidence of oropharyngeal squamous cell carcinoma (OPSCC) in the US is rapidly increasing, driven largely by the epidemic of human papillomavirus (HPV)-mediated OPSCC. Although survival for patients with HPV mediated OPSCC (HPV+ OPSCC) is generally better than that of patients with non-virally mediated OPSCC, this effect is not uniform. We hypothesized that tobacco exposure remains a critical modifier of survival for HPV+ OPSCC patients. We conducted a retrospective analysis of 611 OPSCC patients with concordant p16 and HPV testing treated at a single institute (2002–2013). Survival analysis was performed using Kaplan-Meier analysis and Cox regression. Recursive partitioning analysis (RPA) was used to define tobacco exposure associated with survival (p < 0.05). Tobacco exposure impacted overall survival (OS) for HPV+ patients on univariate and multivariate analysis (p = 0.002, p = 0.003 respectively). RPA identified 30 pack-years (PY) as a threshold at which survival became significantly worse in HPV+ patients. OS and disease-free survival (DFS) for HPV+ > 30 PY patients didn’t differ significantly from HPV- patients (p = 0.72, p = 0.27, respectively). HPV+ > 30 PY patients had substantially lower 5-year OS when compared to their ≤30 PYs counterparts: 78.4% vs 91.6%; p = 0.03, 76% vs 88.3%; p = 0.07, and 52.3% vs 74%; p = 0.05, for stages I, II, and III (AJCC 8th Edition Manual), respectively. Tobacco exposure can eliminate the survival benefit associated with HPV+ status in OPSCC patients. Until this effect can be clearly quantified using prospective datasets, de-escalation of treatment for HPV + OPSCC smokers should be avoided.
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影响因子：
6.2
作者：
Dahlstrom, Kristina R.;Calzada, Gabriel;Hanby, Jennifer D.;Garden, Adam S.;Glisson, Bonnie S.;Li, Guojun;Roberts, Dianna B.;Weber, Randal S.;Sturgis, Erich M.
通讯作者：
Sturgis, Erich M.
DOI：
10.1016/j.ijrobp.2016.02.021
发表时间：
2016-05-01
期刊：
International journal of radiation oncology, biology, physics
影响因子：
--
作者：
Gunn GB;Blanchard P;Garden AS;Zhu XR;Fuller CD;Mohamed AS;Morrison WH;Phan J;Beadle BM;Skinner HD;Sturgis EM;Kies MS;Hutcheson KA;Rosenthal DI;Mohan R;Gillin MT;Frank SJ
通讯作者：
Frank SJ
影响因子：
5.7
作者：
Blanchard, Pierre;Baujat, Bertrand;Pignon, Jean-Pierre
通讯作者：
Pignon, Jean-Pierre
DOI：
10.1016/j.bjoms.2009.03.020
发表时间：
2010-01-01
影响因子：
1.8
作者：
Conway, David I.;McMahon, Alex D.;McKinney, Patricia A.
通讯作者：
McKinney, Patricia A.
影响因子：
5.7
作者：
Hoff, Camilla Molich;Grau, Cai;Overgaard, Jens
通讯作者：
Overgaard, Jens