The Effect of P53 Status and Cigarette/Alcohol Consumption on Prognosis in Patients with P16+/- Oropharyngeal Cancer Receiving Curative or Adjuvant Radiotherapy
Project no. 20875 · Status: Kapanmış (Yayın bekleniyor) · 2019
Summary
Purpose: Human pailloma virus (HPV) is a well-defined etiological factor in oropharyngeal cancer (OPC). In this study, it was aimed to categorize the risk of OPC patients with P16 (+)/(-) and P53 release, smoking/alcohol and other prognostic factors. Material-Method: In this multicenter study, P16/P53 status of 290 patients was evaluated retrospectively, and a risk analysis was created with prognostic factors. According to this risk grouping, in the low risk group: in P16(+) patients, P53(-), ? 10 py cigarettes and low alcohol consumption, low-intermediate risk: in P16(+) patients, P53(+) and/or > 10 py of cigarette or heavy alcohol consumption or in P16(-) patients, P53(-) and T2/3 and N0/2a, high-intermediate risk: in P16(-) patients, P53(+) or T4 or N2b/3, high risk: in P16(-) patients, P53(+) and T4 and/or N2b/3 and/or > 10 py of cigarette or heavy alcohol consumption or continued after treatment. Results: Seventy three% of the patients were >55 years old, 81% were male. Tumor localization was in the tonsil region with a frequency of 47%. P16(+) was found in 33.8% of the patients. Of these patients, 54% consumed >10 py of cigarettes and 18% consumed heavy alcohol. In general, 54% of patients have P53 (+). Fifty nine% of the patients were treated with chemoradiotherapy. Five-year overall survival was 82.6% and 36.9% at P16(+) and (-), respectively. When the prognostic factors are evaluated, P16(-), P53(+), heavy smoking/alcohol consumption, performance status, keratinized morphological type, advanced T and N stages in P16(-), and smoking/alcohol after treatment are unfavorable factors. According to the risk grouping, the 5-year overall survival results were low, low-moderate, high-moderate, high, respectively, 96.3%, 85.1%, 70%, 35.9%. Conclusion: When risk grouping in P16(+) and (-) OFC is evaluated with survival data, it provides us with appropriate results. Evaluating the patient in the most appropriate risk group and offering a treatment option will guide the de-escalation studies to be carried out in this patient group.