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Acta Oncol. 2018 Apr;57(4):541-551. doi: 10.1080/0284186X.2017.1400688. Epub 2017 Nov 17.

Epidemiological and treatment-related factors contribute to improved outcome of oropharyngeal squamous cell carcinoma in Finland.

Author information

1
a Department of Otorhinolaryngology-Head and Neck Surgery , University of Helsinki, Helsinki University Hospital , Helsinki , Finland.
2
b Department of Otorhinolaryngology-Head and Neck Surgery , Tampere University Hospital, University of Tampere , Tampere , Finland.
3
c Department of Otorhinolaryngology-Head and Neck Surgery , Turku University Hospital, University of Turku , Turku , Finland.
4
d Department of Oncology , Helsinki University Hospital, University of Helsinki , Helsinki , Finland.
5
e Department of Otorhinolaryngology-Head and Neck Surgery , Oulu University Hospital, University of Oulu , Oulu , Finland.
6
f Department of Otorhinolaryngology-Head and Neck Surgery , Kuopio University Hospital, University of Eastern Finland , Kuopio , Finland.
7
g Department of Pathology , University of Helsinki, HUSLAB, Helsinki University Hospital , Helsinki , Finland.
8
i Research Programs Unit, Translational Cancer Biology , University of Helsinki , Helsinki , Finland.
9
h Department of Surgery , University of Helsinki, Helsinki University Hospital , Helsinki , Finland.
10
j Department of Oncology , Turku University Hospital, University of Turku , Turku , Finland.
11
k Department of Pathology , Oulu University Hospital, University of Oulu , Oulu , Finland.
12
l Department of Pathology , Turku University Hospital, University of Turku , Turku , Finland.

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.

PMID:
29145765
DOI:
10.1080/0284186X.2017.1400688
[Indexed for MEDLINE]

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