2017 Section 7 Green Book

K UMAR ET AL .

TABLE 1. Patient characteristics.

conducted in SAS version 9.3 (SAS Institute, Cary, NC) or the R language environment for statistical computing (R version 3.1.0).

Characteristics

No. of patients (%)

Age, y, mean (SD)

57.8 (9.2)

Marital status

RESULTS From January 1, 2002, to August 31, 2012, a total of 296 previously untreated patients with oropharyngeal SCC underwent surgical resection for curative intent at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. Patient demographic and clini- cal characteristics are summarized in Table 1. The vast majority of patients were p16-positive (77.1%) and 168 patients (58.5%) were confirmed to be both p16- positive and HPV-positive. Fifty-three patients were p16- positive/HPV-negative by in situ hybridization and 3 were p16-negative/HPV-positive. With regard to surgical approach, 58.8% underwent transoral and 41.2% had open surgical approaches for tumor extirpation. Overall survival Overall 1-, 3-, and 5-year survival rates for all patients, regardless of HPV status, were 88.5%, 71.3%, and 65.1%, respectively. HPV-positive patients had better overall sur- vival than HPV-negative patients (log-rank p value < .0001; see Figure 1). HPV-positive patients had overall survival rates of 94.2%, 83.3%, and 81.8% at 1, 3, and 5 years compared to 79.5%, 53.3%, and 40.3% for HPV- negative patients.

Single/divorced/widowed

115 (41.8) 160 (58.2)

Married

Race

African American/black

12 (4.1)

White

281 (95.9)

Sex

Female

61 (20.6) 235 (79.4) 82 (29.0) 201 (71.0) 84 (28.4) 90 (30.4) 37 (12.5) 50 (16.9) 35 (11.8) 175 (61.2) 111 (38.8) 117 (40.5) 172 (59.5) 239 (81.6) 54 (18.4) 38 (12.9) 57 (19.4) 186 (63.3) 66 (22.9) 222 (77.1) 209 (71.8) 82 (28.2) 74 (25.1) 23 (7.8) 198 (67.1) 106 (38.4) 69 (25.0) 101 (36.6) 129 (46.9) 85 (30.9) 61 (22.8) 11 (3.7) 12 (4.1) 62 (21.1) 209 (71.1) 77 (26.0) 126 (42.6) 48 (16.2) 45 (15.2) 13 (4.4)

Male

Smoking status

10 pack-years > 10 pack-years

Approach TORS

Transoral, nonrobotic

Transcervical (eg, suprahyoid)

Mandibulotomy

Composite resection

ECS

No

Yes

HPV status Negative

Positive

Mucosal margins

Free of carcinoma Positive margins

N classification N0

N1 N2 N3

p16 status Negative

Positive

Perineural invasion No

Yes

Primary site

Base of tongue

Other Tonsil

Rick group, HPV Low

Intermediate

High

Rick group, p16 Low

Intermediate

High

TNM stage I

II

III IV

T classification T1

T2 T3 T4

FIGURE 1. Kaplan–Meier estimates of survival according to human papillomavirus (HPV) status. Patients with HPV-positive tumors had significantly better overall survival than patients with HPV-negative tumors ( p < .0001).

Abbreviations: TORS, transoral robotic surgery; ECS, extracapsular extension; HPV, human papillomavirus.

HEAD & NECK—DOI 10.1002/HED APRIL 2016

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