Prognostic factors in recurrent or metastatic squamous cell carcinoma of the head and neck

Published on Jun 1, 2019in Head and Neck-journal for The Sciences and Specialties of The Head and Neck2.538
· DOI :10.1002/HED.25636
Aurora Mirabile7
Estimated H-index: 7
(University of Milan),
Rosalba Miceli63
Estimated H-index: 63
+ 7 AuthorsLisa Licitra67
Estimated H-index: 67
(University of Milan)
BACKGROUND: In clinical trials of recurrent and metastatic head and neck carcinoma, Argiris et al have identified prognostic factors for overall survival (OS) and progression-free survival (PFS), weight loss, Eastern Cooperative Oncology Group performance status (ECOG-PS), tumor primary site, tumor differentiation, prior radiotherapy, deriving a two-group prognostic classification. This study evaluates Argiris's classification in "field-practice" patients. METHODS: The main analysis included 327 cases; a secondary analysis excluded 31 patients with oropharyngeal carcinoma (OPC) p16-positive and/or human papilloma virus (HPV)-positive. OS and PFS curves were estimated with the Kaplan-Meier method; multivariable Cox analyses were also performed. RESULTS: In the full series, OS was significantly different in patients with 0-2 and ≥3 adverse features (median, 14 vs 10 months; P = .03). PFS was statistically different in the two groups (median, 7 vs 5 months; P = .02). At a multivariable analysis investigating additional prognostic features, site of relapse and disease-free interval were significant predictors of OS and PFS. CONCLUSION: The Argiris's model was confirmed in a "field-practice" population. Moreover, we found additional putative prognostic factors.
#1Carole Fakhry (Johns Hopkins University)H-Index: 37
#2Qiang Zhang (Radiation Therapy Oncology Group)H-Index: 26
Last. Maura L. GillisonH-Index: 81
view all 13 authors...
Purpose Risk of cancer progression is reduced for patients with human papillomavirus (HPV) –positive oropharynx cancer (OPC) relative to HPV-negative OPC, but it is unknown whether risk of death after progression is similarly reduced. Patients and Methods Patients with stage III-IV OPC enrolled onto Radiation Therapy Oncology Group trials 0129 or RTOG 0522 who had known tumor p16 status plus local, regional, and/or distant progression after receiving platinum-based chemoradiotherapy were eligibl...
297 CitationsSource
#1Athanassios Argiris (University of Texas Health Science Center at San Antonio)H-Index: 54
#2Shuli Li (Harvard University)H-Index: 24
Last. Ranee Mehra (Fox Chase Cancer Center)H-Index: 39
view all 8 authors...
Background The purpose of this article was to study the association of human papillomavirus (HPV) with clinical outcomes in patients with recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN).
62 CitationsSource
#1Jan B. VermorkenH-Index: 87
#1J. B. VermorkenH-Index: 1
Last. P. SpecenierH-Index: 1
view all 2 authors...
While a large proportion of patients presenting with stage I and II squamous cell carcinoma of the head and neck (SCCHN) will remain disease free after single modality treatment, the majority of patients presenting in a more advanced disease stage and very often treated with a form of combined modality treatment, will eventually relapse, either locoregionally only, at distant sites only or both. A few patients with a locoregional recurrence can be salvaged by surgery or reirradiation. However, m...
331 CitationsSource
#1K. Kian Ang (University of Texas MD Anderson Cancer Center)H-Index: 116
#2Jonathan HarrisH-Index: 28
Last. Maura L. Gillison (OSU: Ohio State University)H-Index: 81
view all 15 authors...
Background Oropharyngeal squamous-cell carcinomas caused by human papillomavirus (HPV) are associated with favorable survival, but the independent prognostic significance of tumor HPV status remains unknown. Methods We performed a retrospective analysis of the association between tumor HPV status and survival among patients with stage III or IV oropharyngeal squamous-cell carcinoma who were enrolled in a randomized trial comparing accelerated-fractionation radiotherapy (with acceleration by mean...
4,732 CitationsSource
#1Mark E. Zafereo (BCM: Baylor College of Medicine)H-Index: 27
#2Matthew M. Hanasono (University of Texas MD Anderson Cancer Center)H-Index: 24
Last. Randal S. Weber (University of Texas MD Anderson Cancer Center)H-Index: 96
view all 7 authors...
BACKGROUND: The objective of this study was to comprehensively review overall survival, functional outcomes, and prognostic factors in patients who underwent salvage surgery for locally recurrent squamous cell carcinoma of the oropharynx (SCCOP) after initial radiotherapy. METHODS: The authors retrospectively reviewed 1681 consecutive patients who completed definitive therapy for primary SCCOP and identified 168 patients with locally recurrent SCCOP who underwent salvage surgery (41 patients), r...
196 CitationsSource
#1Susan T. Mayne (Yale Cancer Center)H-Index: 9
#2Brenda Cartmel (Yale University)H-Index: 30
Last. W. Jarrard GoodwinH-Index: 26
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As more people begin to survive first cancers, there is an increased need for science-based recommendations to improve survivorship. For survivors of head and neck cancer, use of tobacco and alcohol before diagnosis predicts poorer survival; however, the role of continuing these behaviors after diagnosis on mortality is less clear, especially for more moderate alcohol consumption. Patients ( n = 264) who were recent survivors of early stage head and neck cancer were asked to retrospectively repo...
159 CitationsSource
#1François Janot (Institut Gustave Roussy)H-Index: 31
Last. Jean BourhisH-Index: 84
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Purpose Full-dose reirradiation combined with chemotherapy has been shown to be feasible after salvage surgery with acceptable toxicity. The Groupe d'Etude des Tumeurs de la Tete et du Cou and Groupe d'Oncologie Radiotherapie Tete Et Cou groups performed a randomized study to assess its efficacy. Patients and Methods Between 1999 and 2005, 130 patients with head and neck cancer were treated with salvage surgery and randomly assigned to full-dose reirradiation combined with chemotherapy (RT arm) ...
303 CitationsSource
#1Jan B. Vermorken (University of Antwerp)H-Index: 87
#2Ricard MesiaH-Index: 29
Last. Ricardo Hitt (Complutense University of Madrid)H-Index: 31
view all 18 authors...
Background Cetuximab is effective in platinum-resistant recurrent or metastatic squamous-cell carcinoma of the head and neck. We investigated the efficacy of cetuximab plus platinum-based chemotherapy as first-line treatment in patients with recurrent or metastatic squamous-cell carcinoma of the head and neck. Methods We randomly assigned 220 of 442 eligible patients with untreated recurrent or metastatic squamous-cell carcinoma of the head and neck to receive cisplatin (at a dose of 100 mg per ...
2,229 CitationsSource
#1Athanassios Argiris (NU: Northwestern University)H-Index: 1
#2Yi Li (Harvard University)H-Index: 94
Last. Arlene Forastiere (JHUSOM: Johns Hopkins University School of Medicine)H-Index: 1
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BACKGROUND The current study was conducted to identify prognostic factors and report the characteristics of long-term survivors in patients with recurrent or metastatic carcinoma of the head and neck who were treated with cisplatin-based combination chemotherapy in two randomized, Phase III trials conducted by the Eastern Oncology Cooperative Group (ECOG) (E1393 and E1395). METHODS The authors analyzed prognostic factors for response and survival by combining data from the E1393 trial, which com...
184 CitationsSource
#1Michael K. Gibson (Johns Hopkins University)H-Index: 33
#2Arlene A. Forastiere (Johns Hopkins University)H-Index: 74
Purpose of review Head and neck cancer remains a significant cause of morbidity worldwide, with approximately 400,000 new cases per year. Ongoing advances in multidisciplinary management of this complex and multivaried disease process are resulting in improved function, quality of life, and survival. This review presents selected advances in primary research in head and neck cancer during the year 2003. Recent findings Successful management of head and neck cancer now requires a cooperative appr...
82 CitationsSource
Cited By2
#2Crawford Middleton (University of Strathclyde)
Last. Jenny MontgomeryH-Index: 5
view all 7 authors...
Abstract Persistent hoarseness, as a symptom of laryngeal cancer, is one of the most frequent referrals made in the "urgent suspicion of cancer" (USOC) category in Scotland. This is equivalent to the "2 week wait" category in England. The Scottish Referral Guidelines (SRG) make no exclusions on age of patients with hoarseness, unlike the NICE guidelines (1) which stipulate that referrals are only received for patients 45 years or older. Hoarseness as a presentation of laryngeal cancer is importa...