Human papillomavirus modifies the prognostic significance of T stage and possibly N stage in tonsillar cancer
Human papillomavirus modifies the prognostic significance of T stage and possibly N stage in tonsillar cancer
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DOI：
10.1093/annonc/mds205
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发表时间：
2013-01-01
影响因子：
50.5
通讯作者：
Rose, B.
中科院分区：
文献类型：
--
作者：
Hong, A. M.;Martin, A.;Rose, B.
尽管与更晚期的淋巴结分期有关，但人乳头瘤病毒（HPV）阳性的口咽癌患者的预后更好。我们研究了HPV是否可以改变扁桃体癌已知预后因素的影响。来自10个中心的489例患者接受了中位3.2年的复发或死亡随访。局部复发率、扁桃体癌死亡率和总生存率的决定因素采用考克斯回归模型，T和N分期的预后价值通过HPV修改，如统计学上显著的相互作用项所示。在调整了年龄、性别和治疗后，T分期似乎仅与HPV阳性癌症相关（T分期越高，预后越差）。有一些证据表明，N分期是HPV阴性癌症比HPV阳性癌症更相关的预后因素。没有证据表明HPV改变了年龄、性别或分级对预后的影响，这项研究表明，HPV改变了扁桃体癌传统分期系统的预后意义。
Despite the association with more advanced nodal stage, patients with human papillomavirus (HPV) positive oropharyngeal cancers have better outcomes. We examined whether the HPV can modify the effect of known prognostic factors in tonsillar cancer.A total of 489 patients from 10 centres were followed up for recurrence or death for a median of 3.2 years. Determinants of the rate of locoregional recurrence, death from tonsillar cancer and overall survival were modelled using Cox regression.The prognostic value of T and N stages were modified by HPV as indicated by statistically significant interaction terms. After adjusting for age, gender and treatment, T stage appeared relevant only for HPV-positive cancers (where a higher T stage was associated with worse outcomes). There was some evidence that N stage was a more relevant prognostic factor for HPV-negative than -positive cancers. There was no evidence that the HPV modifies the effect of age, gender or grade on outcomes.This study suggests that the prognostic significance of the conventional staging system in tonsillar cancer is modified by HPV.