The Experts below are selected from a list of 4146 Experts worldwide ranked by ideXlab platform

Robert L. Ferris - One of the best experts on this subject based on the ideXlab platform.

  • Is There a Role for Robotic Surgery in the Treatment of Head and Neck Cancer?
    Current Treatment Options in Oncology, 2016
    Co-Authors: J. Kenneth Byrd, Robert L. Ferris
    Abstract:

    Given the potential for long-term toxicities from concurrent chemoradiation, there is great interest in surgery as a primary treatment modality for head and neck Cancers, particularly in the younger HPV-positive Oropharyngeal Cancer patient. Transoral robotic surgery (TORS) has proven to be an effective technique to safely treat Oropharyngeal and select supraglottic tumors surgically. Sound, traditional surgical principles are employed using improved endoscopic visualization and precise instrumentation to perform oncologic surgery without the morbidity of transmandibular or transcervical approaches. Although level 1 evidence prospective clinical trials are currently underway for TORS, the literature supports its safety and efficacy based on numerous studies. Currently, prospective randomized trials are underway to provide better evidence for or against TORS in Oropharyngeal Cancer. Patient selection based on comorbidities, anatomy, and available pathological data is critical in choosing patients for TORS.

  • Tumor volume as a predictor of survival in HPV positive Oropharyngeal Cancer
    Head & Neck, 2015
    Co-Authors: Kara S. Davis, Chwee Ming Lim, David A. Clump, Dwight E. Heron, James Ohr, Seungwon Kim, Umamaheswar Duvvuri, Jonas T. Johnson, Robert L. Ferris
    Abstract:

    Background Increasing evidence exists that tumor volume may be a superior prognostic model than traditional TNM staging. It has been observed that OPSCC in the setting of human papillomavirus (HPV) positivity have a greater propensity for cystic nodal metastases, and thus presumably larger volume with relatively smaller primary tumors. The influence of HPV status on the predictive value of tumor volume is unknown.

  • The "new" head and neck Cancer patient-young, nonsmoker, nondrinker, and HPV positive: evaluation.
    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2014
    Co-Authors: Daniel G. Deschler, Robert L. Ferris, Jeremy D. Richmon, Samir S. Khariwala, Marilene B. Wang
    Abstract:

    ObjectiveThe near epidemic rise of the incidence of human papillomavirus (HPV)-related Oropharyngeal squamous cell carcinomas (OPSCC) presents the practitioner with a “new” head and neck Cancer patient, vastly different from those with the traditional risk factors who formed the basis of most practitioners’ training experience. Accordingly, a thorough and disease-specific evaluation process is necessitated. This article will review the evaluation of the HPV-related Cancer patient, including a review of the HPV-positive Oropharyngeal Cancer epidemic from the surgeon’s perspective, evaluation of the primary lesion, evaluation of the neck mass, and role of imaging, to provide a framework for addressing the challenging questions patients may ask.Data SourcesAvailable peer-reviewed literature and practice guidelines.Review MethodsAssessment of selected specific topics by authors solicited from the Head and Neck Surgery and Oncology Committee of the American Academy of Otolaryngology—Head and Neck Surgery Found...

  • The New Cancer Patient: Young, Non-smoker, HPV+: Evaluation
    Otolaryngology–Head and Neck Surgery, 2013
    Co-Authors: Daniel G. Deschler, Robert L. Ferris, Samir S. Khariwala, Marilene B. Wang, Jeremy D. Richmon
    Abstract:

    Program Description:The near-epidemic rise of the incidence of human papillomavirus (HPV)-related Oropharyngeal carcinomas presents the practitioner with a “new” head and neck Cancer patient, vastly different from those with the traditional risk factors who formed the basis of our training experience. Accordingly, a thorough and disease-specific evaluation process is necessitated. Using a case-based format and the following presentations from experts in the field, this miniseminar will review the evaluation of the HPV-related Cancer patient: The HPV Oropharyngeal Cancer epidemic: surgeon’s perspective, role of imaging, evaluation of the neck mass, evaluation of the primary questions every patient wants to ask.Educational Objectives:1) Recognize the key clinical, epidemiological and pathologic features differentiating HPV-positive Oropharyngeal Cancer from Cancers related to traditional risk factors. 2) Implement a consistent, efficient, and evidence-based evaluation process for the increasing number of pa...

Marshall R. Posner - One of the best experts on this subject based on the ideXlab platform.

  • Window of opportunity trial of HPV E7 antigen-expressing Listeria-based therapeutic vaccination prior to robotic surgery for HPV-positive Oropharyngeal Cancer.
    Journal of Clinical Oncology, 2015
    Co-Authors: Brett A. Miles, Rosemarie Krupar, Eric M. Genden, Krzys Misiukiewicz, Elizabeth G. Demicco, Michael J. Donovan, Marshall R. Posner, Sacha Gnjatic, Yvonne M. Saenger, Andrew G. Sikora
    Abstract:

    TPS6088 Background: The incidence of human papilloma virus-associated Oropharyngeal Cancer (HPVOPC) has rapidly risen over the past two decades. Foreign viral antigens make HPVOPC an attractive target for immunotherapy. One exciting approach is the use of live attenuated Listeria monocytogenesbioengineered to express the HPV16 E7 protein (LmE7) and elicit a vigorous immune response. We designed a phase II “window of opportunity” trial with robust correlative endpoints to determine the effect of LmE7 vaccination on anti-tumor immunity in the tumor microenvironment and peripheral blood, as well as safety and tolerability in the HPVOPC population. Methods: Trial Design: Non-randomized single-arm phase II clinical trial utilizing a Simon’s two-stage design. HPVOPC patients receive two cycles of LmE7 over 5 weeks prior to standard-of-care transoral surgical resection of their tumor with or without neck dissection. The primary objective is to determine the rate of post-vaccination T cell responses by measuring ...

  • Abstract 626: Cisplatin-based concurrent chemoradiotherapy antagonizes anti-tumor immunity in patients with HPV-positive Oropharyngeal Cancer
    Clinical Research (Excluding Clinical Trials), 2014
    Co-Authors: Andrew G. Sikora, Krzys Misiukiewicz, Falguni Parikh, Seunghee Kim-schulze, Marshall R. Posner, Vishal Gupta, Alexis Patsias, Amelia Clark, Dorothée Duluc
    Abstract:

    Proceedings: AACR Annual Meeting 2014; April 5-9, 2014; San Diego, CA Purpose/Objectives: While viral antigens in HPV-related Oropharyngeal Cancer (HPVOPC) make it an attractive target for immunotherapy, understanding the immune effects of existing therapeutic approaches is essential for integrating immunotherapy into HPVOPC treatment. Preclinical data in several Cancer models support an overall immunostimulatory effect of chemotherapy and radiation; however their effect on HPV-specific immunity on HPVOPC patients is unknown. We tested the hypotheses that platinum-based concomitant chemoradiation, with or without taxane-platinum-5FU (TPF) induction chemotherapy, induces a favorable profile of circulating immunocytes ad enhanced HPV-specific T cell responses in HPVOPC patients. Materials/Methods: Patients with stage II-IV HPVOPC treated with standard-of-care chemoradiation underwent serial blood sampling before, during, and after treatment for up to one year. Circulating immunocytes including effector CD4+ and CD8+ T cells and immunosuppressive regulatory T cells (Treg) and myeloid-derived suppressor cells (MDSC) were profiled by flow cytometry. Expression levels of the negative costimulatory molecule PD-1 on T cells were also assessed by flow cytometry. HPV antigen-specific T cell responses in response to HPV16 E6 and E7 peptides were measured by luminex analysis of IFN-γ production. Results: Pre-treatment HPV-specific T cell responses were present in 12/18 patients, and an additional 4 patients acquired measureable responses following induction chemotherapy. Of the 16 patients who developed HPV-specific responses before completion of therapy, 10 lost these responses by 3 months post-treatment. The average level of IFN-g release by PBMC after stimulation with HPV peptides was non-significantly decreased at 3 weeks post-treatment, and significantly decreased at 3 and 6 months. Loss of pre-existing tumor-specific immune responses was associated with a striking (2-fold) decline in circulating CD4+ and CD8+ T cell numbers, a lesser decline in Treg (1.5-fold), marked elevation of MDSC (>2-fold), and decline in the CD8+:Treg and CD8+:MDSC ratios following chemoradiotherapy. PD-1 expression levels on total and CD45RO+ (memory) CD4+ T cells were elevated at 3 weeks after completion of chemoradiation, returning to baseline by 3 months. Conclusions: Contrary to our starting hypothesis, we found an overall immunosuppressive effect of chemoradiotherapy on immune responses in HPVOPC patients. Upregulation of PD-1 on CD4 T cells is a potential immunosuppressive mechanism amenable to targeted therapy with clinically available anti-PD-1 and anti-PD-L1 antibodies. Taken together, our results suggest that chemoradiation has profound effects on circulating immunocyte populations and the immune response to HPV+ OPC, and highlight the importance of further studies of the immune effects of standard-of-care treatment for HPVOPC. Citation Format: Andrew Sikora, Marshall Posner, Falguni Parikh, Seunghee Kim-Schulze, Vishal Gupta, Krzysztof Misiukiewicz, Alexis Patsias, Amelia Clark, Sangkon Oh, Dorothee Duluc. Cisplatin-based concurrent chemoradiotherapy antagonizes anti-tumor immunity in patients with HPV-positive Oropharyngeal Cancer. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 626. doi:10.1158/1538-7445.AM2014-626

  • Oral Human Papillomavirus (HPV) Infection in HPV-positive Patients With Oropharyngeal Cancer and Their Partners
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2014
    Co-Authors: Gypsyamber D'souza, Neil D. Gross, Sara I. Pai, Robert I. Haddad, Maura L. Gillison, Karen S. Anderson, Shirani D. Rajan, Jennifer E. Gerber, Marshall R. Posner
    Abstract:

    Purpose To better understand oral human papillomavirus (HPV) infection and Cancer risk among long-term sexual partners of patients with HPV-positive Oropharyngeal Cancer (HPV-OPC). Patients and Methods An oral rinse sample, risk factor survey, Cancer history, and oral examination (partners only) were collected from patients with HPV-OPC and their partners. Oral rinse samples were evaluated for 36 types of HPV DNA using PGMY 09/11 primers and line-blot hybridization and HPV16 copy number using quantitative polymerase chain reaction. Oral HPV prevalence was compared with infection among those age 45 to 65 years using National Health and Nutrition Examination Survey (NHANES) 2009-2010. Results A total of 164 patients with HPV-OPC and 93 of their partners were enrolled. Patients were primarily men (90%), were never-smokers (51%), and had performed oral sex (97%), with a median age of 56 years; they had a high prevalence of oncogenic oral HPV DNA (61%) and oral HPV16 DNA (54%) at enrollment. Female partners ha...

  • Oral HPV infection in HPV-positive Oropharyngeal Cancer cases and their spouses.
    Journal of Clinical Oncology, 2013
    Co-Authors: Gypsyamber D'souza, Neil D. Gross, Sara I. Pai, Robert I. Haddad, Maura L. Gillison, Marshall R. Posner
    Abstract:

    CRA6031 Background: Incidence of human papillomavirus-positive Oropharyngeal Cancer (HPV-OPC) is increasing, and spouses of these patients have high anxiety about their own HPV-related Cancer risk. Methods: Partner study of 149 HPV-OPC and 81 of their spouse/long-term partners. Data collection included a 30-second rinse and gargle (at diagnosis and again 1 year later for 103 cases and 46 partners), computer-assisted risk factor survey, tumor collection (cases), and visual oral examination (spouses). Oral rinse samples were tested for 36 types of HPV DNA using PGMY09/11 primers and line-blot amplification, and HPV16 copy-number using real-time PCR. Results: Cases were primarily male (89%), white non-Hispanic (92%), had performed oral sex (94%), and never-smokers (51%) with a median age of 56 years. Twelve-month survival was high among never- and ever-smoking HPV-OPC (100% vs 93%, p=0.18). The 81 spouses of HPV-OPC were primarily female (81%), white non-Hispanic (92%), never-smokers (54%), with a median age of 53 years. Spouses were significantly less likely than cases to have >10 lifetime oral sex partners (11% vs 39%, p<0.001). Prevalence of any oral HPV (65%) and oral HPV16 (52%) was high among HPV-OPC at diagnosis. Four (7.7%) of 52 HPV-OPC with HPV16 DNA detectable before therapy, had HPV16 persistently detected one year after diagnosis/therapy. Prevalence of any oral HPV DNA among partners was significantly lower than among HPV-OPC (7.3% vs 65%, p<0.001). Oral HPV prevalence was significantly higher among the 7 male partners than the 74 female partners (29% vs 5%, p=0.025). Oral HPV infections among partners included HPV16 (n=2), HPV62 (n=2), HPV 83 and 51 (1 each). Both partners with oral HPV16 infections were female and no longer had oral HPV16 detected at the one year follow-up. 64% of spouses had a visual oral exam, and no pre-Cancers or Cancers were identified. However, two (2.5%) enrolled spouses reported a personal history of cervical Cancer, and 6 HPV-HNC cases (4.0%) reported a previous spouse who developed cervical or vaginal Cancer. Conclusions: Oral HPV16 DNA is common among HPV-OPC, but not among their spouses. Spouses of HPV-OPC may have an elevated risk or history of cervical Cancer.

  • Oral HPV infection in HPV-positive Oropharyngeal Cancer cases and their spouses.
    Journal of Clinical Oncology, 2013
    Co-Authors: Gypsyamber D'souza, Neil D. Gross, Sara I. Pai, Robert I. Haddad, Maura L. Gillison, Marshall R. Posner
    Abstract:

    CRA6031 Background: Incidence of human papillomavirus-positive Oropharyngeal Cancer (HPV-OPC) is increasing, and spouses of these patients have high anxiety about their own HPV-related Cancer risk. Methods: Partner study of 149 HPV-OPC and 81 of their spouse/long-term partners. Data collection included a 30-second rinse and gargle (at diagnosis and again 1 year later for 103 cases and 46 partners), computer-assisted risk factor survey, tumor collection (cases), and visual oral examination (spouses). Oral rinse samples were tested for 36 types of HPV DNA using PGMY09/11 primers and line-blot amplification, and HPV16 copy-number using real-time PCR. Results: Cases were primarily male (89%), white non-Hispanic (92%), had performed oral sex (94%), and never-smokers (51%) with a median age of 56 years. Twelve-month survival was high among never- and ever-smoking HPV-OPC (100% vs 93%, p=0.18). The 81 spouses of HPV-OPC were primarily female (81%), white non-Hispanic (92%), never-smokers (54%), with a median age...

Brandon A Mahal - One of the best experts on this subject based on the ideXlab platform.

  • trimodality therapy for hpv positive Oropharyngeal Cancer a population based study trimodality therapy for hpv opc
    Oral Oncology, 2019
    Co-Authors: Nina N Sanford, William L Hwang, Luke R G Pike, Allen C Lam, Trevor J Royce, Brandon A Mahal
    Abstract:

    Abstract Background Although HPV status is a well-established prognostic factor in Oropharyngeal squamous cell carcinoma (OPSCC), approximately 20% of HPV-positive patients die from their disease. We therefore sought to ascertain whether there is a benefit to trimodality therapy with surgery among patients with locally advanced (LA) disease receiving chemoradiation. Methods The SEER Head and Neck with HPV Status Database identified adult patients with non-metastatic OPSCC between 2013 and 2014 with known HPV status who received chemoradiation as part of definitive treatment. The primary outcome was Cancer-specific mortality (CSM) for locally-advanced (LA) (T3-T4, or N2-N3, per AJCC 7) versus early-stage (ES) (T1-T2 and N0-N1) disease, stratified by HPV status. The secondary outcome was overall survival (OS). Results Among 2974 patients who met study criteria, 671 patients (22.6%) received upfront surgery (trimodality therapy). In the LA setting, there was a significant reduction in CSM with trimodality therapy compared to chemoradiation alone in HPV-positive (Adjusted Hazard Ratio [AHR] 0.19, 95% Confidence Interval [CI] 0.04–0.80; P = 0.024), but not HPV-negative disease [Pinteraction = 0.04]. There was no benefit to trimodality therapy for ES disease, regardless of HPV status. There was also an improvement in OS with trimodality therapy for HPV-positive LA patients (AHR = 0.28, p = 0.006, 95% CI = 0.11–0.70). In contrast, trimodality therapy was not associated with improved OS for HPV-negative patients regardless of stage. Conclusions HPV status may predict for improved outcomes with surgery/trimodality therapy in LA OPSCC. Our findings support prospective investigations to optimize care for the subset of HPV-positive patients who are at greatest risk of Cancer death, where trimodality therapy may be appropriate.

Erich M. Sturgis - One of the best experts on this subject based on the ideXlab platform.

  • Lymphocyte telomere length predicts clinical outcomes of HPV-positive Oropharyngeal Cancer patients after definitive radiotherapy
    Carcinogenesis, 2019
    Co-Authors: Xiaoning Luo, Erich M. Sturgis, Zheng Yang, Yan Sun, Peng Wei, Zhensheng Liu, Qingyi Wei
    Abstract:

    Because lymphocyte telomere length (LTL) plays critical roles in the maintenance of genomic stability and integrity, LTL thus may influence the etiology and prognosis of squamous cell carcinoma of the oropharynx (SCCOP). However, given the association between LTL and risk of human papillomavirus (HPV)-associated SCCOP and between LTL and tumor HPV status of SCCOP, we hypothesized that LTL is associated with SCCOP prognosis, particularly in HPV-positive patients after definitive radiotherapy. LTL and tumor HPV type 16 (HPV16) status were determined in 564 incident SCCOP patients before radiotherapy or chemoradiation. Both univariate and multivariable Cox regression analyses were performed to estimate the association between LTL and prognosis. Eighty-five percent patients had HPV16-positive tumors. Patients with shorter telomeres had significantly better overall, disease-specific and disease-free survival than did those with longer telomeres (log-rank P < 0.001). Moreover, patients with shorter telomeres had significantly lower risk of death overall [hazard ratio (HR) = 0.2; 95% confidence interval (CI) = 0.1-0.4], death due to SCCOP (HR = 0.2; 95% CI = 0.1-0.4) and SCCOP recurrence (HR = 0.3; 95% CI = 0.2-0.5) after adjusting for other important prognostic confounders. Finally, we found more pronounced effects of LTL on survival in HPV16-positive SCCOP patients after stratified analysis according to tumor HPV status. These findings indicate that LTL plays a significant role in the survival of patients with SCCOP, especially HPV16-positive patients who undergo definitive radiotherapy. Therefore, pretreatment LTL may be an independent prognostic biomarker for HPV16-positive SCCOP. Prospective studies with larger sample sizes are needed to confirm these findings.

  • Significance of Negative Posttreatment 18-FDG PET/CT Imaging in Patients With p16/HPV-positive Oropharyngeal Cancer.
    International journal of radiation oncology biology physics, 2018
    Co-Authors: Jason M. Johnson, Erich M. Sturgis, G. Brandon Gunn, David I. Rosenthal, Heath D. Skinner, Jack Phan, Steven J. Frank, William H. Morrison, Frank E. Mott
    Abstract:

    Purpose Patients with p16/human papilloma virus (HPV)–associated Oropharyngeal squamous cell carcinoma have a favorable outcome after treatment. In this group of patients who could have a long life expectancy, the optimal surveillance strategy and modality is not well established. We aim to determine the ability of a negative postradiation positron emission tomography (PET)/computed tomography scan to predict the risk of subsequent relapse in these patients. Materials and Methods A retrospective analysis of patients with p16/HPV-associated Oropharyngeal squamous cell carcinoma who completed definitive (chemo)radiation therapy and had a posttreatment PET/computed tomography scan from 2006 to 2013 was performed. Patient, tumor, and treatment characteristics and clinical outcomes were recorded. Tumors were considered HPV/p16 positive if either HPV (by in situ hybridization) or p16 (by immunohistochemistry) was positive. Disease-free survival and overall survival rates were estimated using the Kaplan-Meier method. Results In our study, 327 patients were evaluated. The median age was 57 years. The most common primary sites were base of tongue (50%) and tonsil (48%). Of the patients evaluated, 291 (89%) had a negative posttreatment PET scan. For these 291 patients who had a complete metabolic response after treatment, the 5-year disease-free survival and overall survival rates were 91% and 89%, respectively. The median time to development of recurrence was 16 months. Of the 291 patients, 24 patients (8%) had disease recurrence; 13 recurrences were locoregional, and 13 were distant. Eleven (4%) patients with recurrence had further surgery or radiation, and 8 patients (3%) were without disease as of the last follow-up. Conclusions Patients who achieve a complete metabolic response on posttreatment PET imaging have an excellent prognosis, and the risk of developing a recurrence in the future is very low. Therefore, a more cost effective surveillance program should be considered for this subgroup of patients.

  • TGFβ1 Genetic Variants Predict Clinical Outcomes of HPV-positive Oropharyngeal Cancer Patients after Definitive Radiotherapy.
    Clinical cancer research : an official journal of the American Association for Cancer Research, 2018
    Co-Authors: Ye Tao, Erich M. Sturgis, Peng Wei, Zhigang Huang, Ying Wang, Jennifer Wang, Qingyi Wei
    Abstract:

    Purpose: TGFβ1 plays a critical role in inflammation and immune responses and treatment response and survival. TGFβ1 variants may affect its expression level or functional efficiency, thus modifying tumor status and survival in human papillomavirus (HPV)-positive squamous cell carcinoma of the oropharynx (SCCOP).Experimental Design: We determined tumor HPV16 status and genotyped three TGFβ1 polymorphisms in 564 incident SCCOP patients treated with radiotherapy or chemoradiation. Univariate and multivariable Cox models were used to evaluate the associations between the three polymorphisms and survival.Results: Overall, 85% of patients (482 of 564) had HPV16-positive SCCOP. We found that TGFβ1 rs1982073 had statistically significant associations with survival, whereas TGFβ1 rs1800469 and TGFβ1 rs1800471 did not. Patients with TGFβ1 rs1982073 CT/CC variant genotypes had significantly better overall, disease-specific, and disease-free survival compared with those with the corresponding common homozygous TT genotype (all log-rank: P < 0.001). Furthermore, these genotypes were significantly associated with an approximately 5 times reduced risk of overall death, death owing to disease, and recurrence after multivariable adjustment. Moreover, the stratified analyses by tumor HPV status indicated that the significant effects of TGFβ1 rs1982073 polymorphism on survival were found among HPV16-positive SCCOP patients only. Finally, the functional relevance of these variants was further characterized.Conclusions: Our findings support that the TGFβ1 rs1982073 polymorphism plays a significant role in the prognosis of SCCOP, especially in HPV16-positive SCCOP patients treated with chemoradiation. Prospective studies with larger sample sizes are needed to confirm these findings. Clin Cancer Res; 24(9); 2225-33. ©2018 AACR.

  • Association Between Hepatitis C Virus and Head and Neck Cancers
    Journal of the National Cancer Institute, 2016
    Co-Authors: Parag Mahale, Erich M. Sturgis, David J. Tweardy, Ella J. Ariza-heredia, Harrys A. Torres
    Abstract:

    Background: Hepatitis C virus (HCV) infection is associated with hepatocellular carcinoma and non-Hodgkin’s lymphoma. In 2009, MD Anderson established the first US clinic for treating HCV-infected Cancer patients, where we observed an unexpectedly large number of patients with head and neck Cancers (HNCs). We sought to determine whether HCV is associated with HNCs. Methods: In this case-control study, medical records of Cancer patients tested for HCV antibodies at our center from 2004 through 2014 were identified. Case subjects had new-onset primary Oropharyngeal or nonOropharyngeal (oral cavity, nasopharynx, hypopharynx, or larynx) HNCs. Control subjects had smoking-associated (lung, esophagus, or urinary bladder) Cancers. Biopsy reports of Oropharyngeal Cancers tested for human papillomavirus (HPV) were reviewed. Patients with lymphoma were excluded. Multivariable logistic regression models were constructed. All statistical tests were two-sided. Results: Of 34 545 Cancer patients tested for HCV antibodies, 409 case subjects (164 Oropharyngeal and 245 nonOropharyngeal) and 694 control subjects (378 lung, 168 esophagus, and 148 urinary bladder) were studied. The prevalence of HCV seropositivity was higher in Oropharyngeal Cancer patients (14.0%, 95% confidence interval [CI] = 8.7% to 19.4%, vs 6.5%, 95% CI = 4.6% to 8.3%), particularly HPV-positive Oropharyngeal Cancer patients (16.9%, 95% CI = 8.7% to 24.9%, vs 6.5%, 95% CI = 4.6% to 8.3%), and nonOropharyngeal HNC patients (20.0%, 95% CI = 14.9% to 25.0%, vs 6.5%, 95% CI = 4.6% to 8.3%) than in control subjects. Adjusted models showed a statistically significant association of HCV seropositivity with nonOropharyngeal (except nasopharyngeal) HNCs (odds ratio [OR] = 2.85, 95% CI = 1.38 to 5.88) and HPV-positive Oropharyngeal Cancers (OR = 2.97, 95% CI = 1.31 to 6.76). Conclusions: HCV is associated with nonOropharyngeal (except nasopharyngeal) and HPV-positive Oropharyngeal HNCs. Further studies are required to explore the possible interaction between HCV and HPV, and the association between HCV and other HPV-related malignancies.

  • Epidemiology of Oral HPV Infection and HPV-Associated Head and Neck Cancer
    HPV and Head and Neck Cancers, 2015
    Co-Authors: Kristina R. Dahlstrom, Erich M. Sturgis
    Abstract:

    Tobacco and alcohol exposure are the traditional risk factors for malignancies of the head and neck, and account for approximately three-quarters of all cases worldwide and half of the cases in the USA [1]. Infection with human papillomavirus (HPV), particularly type 16, has also been established as yet another important risk factor [2–5]. The overwhelming majority of HPV-associated head and neck Cancers (HPV-HNSCCs) arise from the oropharynx [2, 6]. HPV-positive Oropharyngeal Cancer (OPC) represents a growing aetiologically distinct subset of head and neck Cancers, with unique epidemiological, clinical and molecular characteristics that differ from those of HPV-negative Cancers.

Allen C Lam - One of the best experts on this subject based on the ideXlab platform.

  • trimodality therapy for hpv positive Oropharyngeal Cancer a population based study trimodality therapy for hpv opc
    Oral Oncology, 2019
    Co-Authors: Nina N Sanford, William L Hwang, Luke R G Pike, Allen C Lam, Trevor J Royce, Brandon A Mahal
    Abstract:

    Abstract Background Although HPV status is a well-established prognostic factor in Oropharyngeal squamous cell carcinoma (OPSCC), approximately 20% of HPV-positive patients die from their disease. We therefore sought to ascertain whether there is a benefit to trimodality therapy with surgery among patients with locally advanced (LA) disease receiving chemoradiation. Methods The SEER Head and Neck with HPV Status Database identified adult patients with non-metastatic OPSCC between 2013 and 2014 with known HPV status who received chemoradiation as part of definitive treatment. The primary outcome was Cancer-specific mortality (CSM) for locally-advanced (LA) (T3-T4, or N2-N3, per AJCC 7) versus early-stage (ES) (T1-T2 and N0-N1) disease, stratified by HPV status. The secondary outcome was overall survival (OS). Results Among 2974 patients who met study criteria, 671 patients (22.6%) received upfront surgery (trimodality therapy). In the LA setting, there was a significant reduction in CSM with trimodality therapy compared to chemoradiation alone in HPV-positive (Adjusted Hazard Ratio [AHR] 0.19, 95% Confidence Interval [CI] 0.04–0.80; P = 0.024), but not HPV-negative disease [Pinteraction = 0.04]. There was no benefit to trimodality therapy for ES disease, regardless of HPV status. There was also an improvement in OS with trimodality therapy for HPV-positive LA patients (AHR = 0.28, p = 0.006, 95% CI = 0.11–0.70). In contrast, trimodality therapy was not associated with improved OS for HPV-negative patients regardless of stage. Conclusions HPV status may predict for improved outcomes with surgery/trimodality therapy in LA OPSCC. Our findings support prospective investigations to optimize care for the subset of HPV-positive patients who are at greatest risk of Cancer death, where trimodality therapy may be appropriate.