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Carcinoma of the Oropharynx: Factors Affecting Outcome
Author(s) -
Sundaram Krishnamurthi,
Schwartz Jerome,
HarEl Gady,
Lucente Frank
Publication year - 2005
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/01.mlg.0000175075.69706.64
Subject(s) - outcome (game theory) , medicine , oncology , mathematics , mathematical economics
Objectives/Hypothesis: To assess the value of both patient‐ and tumor‐related factors of oropharyngeal squamous cell carcinoma in predicting patient outcome, with respect to the three primary subsites of the disease. It was hypothesized that the subsite has a significant impact on outcome. Study Design: Historical cohort study. Methods: A chart review was conducted of 126 patients diagnosed with squamous cell carcinoma of the oropharynx over a 10‐year period. The oropharynx was divided into the following subsites: 1) base of tongue, 2) tonsil and pillars, and 3) uvula, soft palate, and posterior pharyngeal wall. Patient‐related factors included age and gender. Tumor‐related factors included American Joint Committee on Cancer stage, T stage, N stage, and grade. These factors were compared using the end points of disease‐free survival and treatment response (complete response or partial response/no response). Results: Tumor‐related factors such as American Joint Committee on Cancer stage ( P = .016) and T stage ( P = .008) had a significant impact on treatment response. The American Joint Committee on Cancer stage ( P = .030) and the T stage ( P = .005) were also significant predictors of disease‐free survival. Base‐of‐tongue lesions responded significantly worse to treatment than did tonsil and pillar or uvula, soft palate, and posterior pharyngeal wall lesions ( P = .014). The disease‐free survival for base‐of‐tongue cancer was significantly worse than for tonsil and pillar or for uvula, soft palate, and posterior pharyngeal wall cancer ( P = .010). Conclusion: Patient‐related factors such as age and gender were not significant in predicting disease‐specific outcome. Important tumor‐related factors were the American Joint Committee on Cancer stage and the T stage. Among the oropharyngeal subsites, squamous cell carcinoma of the base of tongue was associated with the worst outcome.