{Reference Type}: Journal Article
{Title}: Optimization of therapeutic strategy for p16-positive oropharyngeal squamous cell carcinoma: Multi-institutional observational study based on the national Head and Neck Cancer Registry of Japan.
{Author}: Saito Y;Hayashi R;Iida Y;Mizumachi T;Fujii T;Matsumoto F;Beppu T;Yoshida M;Shinomiya H;Kamiyama R;Kitano M;Yokoshima K;Fujimoto Y;Hama T;Yamashita T;Okami K;Miura K;Fujisawa T;Sano D;Kato H;Minami S;Sugasawa M;Masuda M;Ota I;Iwae S;Kawata R;Monden N;Imai T;Asakage T;Okada M;Yoshikawa T;Tanioka K;Kitayama M;Doi M;Fujii S;Fujii M;Oridate N;Nakamizo M;Yoshimoto S;Homma A;Nibu KI;Yane K;
{Journal}: Cancer
{Volume}: 126
{Issue}: 18
{Year}: 09 2020 15
{Factor}: 6.921
{DOI}: 10.1002/cncr.33062
{Abstract}: Although the American Joint Committee on Cancer TNM classification has been amended to include human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) as an independent entity, to the authors' knowledge the optimized de-escalating treatment modality has not been established to date.<BR>The authors conducted a retrospective, nationwide, observational study in patients with HPV-related OPSCC who were treated from 2011 to 2014 in Japan to determine the best treatment modality.<BR>A total of 688 patients who were newly diagnosed with HPV-related OPSCC who were treated with curative intent at 35 institutions and had coherent clinical information and follow-up data available were included in the current study. In patients with T1-T2N0 disease (79 patients), both the 3-year recurrence-free survival and overall survival (OS) rates were 100% in the group treated with radiotherapy (RT) as well as the group receiving concurrent chemoradiotherapy (CCRT). The 3-year OS rates were 94.4% (for patients with T1N0 disease) and 92.9% (for patients with T2N0 disease) among the patients treated with upfront surgery. In patients with stage I to stage II HPV-related OPSCC, the 5-year recurrence-free survival and OS rates were 91.4% and 92%, respectively, in the patients treated with CCRT with relatively high-dose cisplatin (≥160 mg/m2 ; 114 patients) and 74.3% and 69.5%, respectively, in the patients treated with low-dose cisplatin (<160 mg/m2 ; 17 patients).<BR>Despite it being a retrospective observational trial with a lack of information regarding toxicity and morbidity, the results of the current study demonstrated that patients with T1-T2N0 HPV-related OPSCC could be treated with RT alone because of the equivalent outcomes of RT and CCRT, and patients with stage I to stage II HPV-related OPSCC other than those with T1-T2N0 disease could be treated with CCRT with cisplatin at a dose of ≥160 mg/m2 .