Fax: (713) 794-4662
An evolution in demographics, treatment, and outcomes of oropharyngeal cancer at a major cancer center
A staging system in need of repair
Article first published online: 26 JUN 2012
Copyright © 2012 American Cancer Society
Volume 119, Issue 1, pages 81–89, 1 January 2013
How to Cite
Dahlstrom, K. R., Calzada, G., Hanby, J. D., Garden, A. S., Glisson, B. S., Li, G., Roberts, D. B., Weber, R. S. and Sturgis, E. M. (2013), An evolution in demographics, treatment, and outcomes of oropharyngeal cancer at a major cancer center. Cancer, 119: 81–89. doi: 10.1002/cncr.27727
- Issue published online: 17 DEC 2012
- Article first published online: 26 JUN 2012
- Manuscript Accepted: 1 JUN 2012
- Manuscript Revised: 31 MAY 2012
- Manuscript Received: 3 APR 2012
- head and neck cancer;
- head and neck neoplasms;
- human papillomavirus;
- oropharyngeal cancer;
- neoplasm staging
In this retrospective review, the authors examined demographic/clinical characteristics and overall survival in patients with squamous cell carcinoma of the oropharynx at a tertiary cancer center, and they report the characteristics that influenced any observed survival trends over time.
The study included 3891 newly diagnosed, previously untreated patients who presented at the authors' institution between 1955 and 2004.
Over time, patients presented at younger ages and were more likely to have base of tongue or tonsil tumors and to be never-smokers or former smokers. Patients who were diagnosed between 1995 and 2004 were almost half as likely to die as those who were diagnosed before 1995 (hazard ratio, 0.6; 95% confidence interval, 0.6-0.8). In both multivariable and recursive partitioning survival analyses, the TNM staging system predicted the survival of patients who received treatment before 1995 but did not predict the survival patients treated during the period from 1995 to 2004.
Survival among patients with squamous cell carcinoma of the oropharynx improved substantially over the past 50 years. The main contributing factors were changes in clinical characteristics, in particular surrogates for positive human papillomavirus status. The current TNM staging system for squamous cell carcinoma of the oropharynx is inadequate. The incorporation of human papillomavirus status and perhaps smoking status into the TNM system is encouraged. Cancer 2013. © 2012 American Cancer Society.