The applicability of new TNM classification for humanpapilloma virus-related oropharyngeal cancer in the 8th edition of the AJCC/UICC TNM staging system in Japan: A single-centre study

Publication date: Available online 29 July 2017
Source:Auris Nasus Larynx
Author(s): Daisuke Sano, Kenichiro Yabuki, Yasuhiro Arai, Teruhiko Tanabe, Yoshihiro Chiba, Goshi Nishimura, Hideaki Takahashi, Shoji Yamanaka, Nobuhiko Oridate
ObjectiveThe purpose of this study is to validate the applicability of new TNM classification for human papillomavirus (HPV)-related oropharyngeal cancer (OPC) in the 8th edition of the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) TNM staging system in Japan.MethodsA total of 91 OPC patients treated with radiation-based therapy between January 2011 and December 2016 were analyzed retrospectively in this study. HPV infection status was evaluated using tumor p16 expression.Results40 OPC patients (44.0%) had HPV-positive disease in this study. The distribution of disease stage of HPV-positive OPC patients dramatically changed from the 7th edition to the 8th edition of AJCC/UICC TNM classification. However, neither the 8th edition nor the 7th edition of the AJCC/UICC TNM staging system could adequately predict outcomes of HPV-positive OPC patients in our patient series. On the other hand, our multivariate analysis indicated that matted nodes and age ≥63 were independent prognostic factors for progression-free survival. In addition, HPV-positive OPC patients with stage I without matted nodes showed significantly better OS and PFS compared with those with stage I with matted nodes and stages II and III in the 8th edition of the AJCC/UICC TNM staging system (P=0.008, and P=0.043, respectively).ConclusionOur results suggested that matted nodes of HPV-positive OPC patients might be additionally examined to apply the 8th edition of AJCC/UICC TNM classification for more adequate predicting outcomes of HPV-positive OPC patients.



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