Oral oncology · 2025
Outcomes of oropharyngeal squamous cell carcinoma among patients with lymphoproliferative disorders.
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Williams Marta M, Hanna Glenn J, Sethi Rosh K, Rettig Eleni M
Аннотация
INTRODUCTION: Human Papillomavirus (HPV) causes most oropharynx squamous cell carcinomas (OPCs) in the U.S. Immune suppression is associated with both HPV infection and lymphoproliferative disorders (LPD), yet little is known about outcomes among patients with both diagnoses. This study evaluated clinical characteristics and survival in patients diagnosed with both OPC and LPD.
METHODS: We conducted a retrospective study of patients evaluated at Dana-Farber Cancer Institute from 2001 to 2020 with diagnoses of both OPC and LPD (leukemia or lymphoma). Demographic and clinical data were compared by order of diagnosis, and overall survival (OS) from OPC diagnosis was analyzed.
RESULTS: Among 53 patients, 38 % were diagnosed with OPC first and 62 % with LPD first. Median ages at OPC and LPD diagnoses were 62 and 61 years, respectively. Fiftyseven percent of OPCs were HPV-positive. Patients with prior LPD were more likely to undergo surgery (51 % vs 30 %) and less likely to receive radiation (66 % vs 100 %) for OPC (p = 0.03), despite similar disease stage. Patients with HPV-negative OPC had significantly worse OS than those with HPV-positive tumors (HR 5.6, 95 %CI2.2-14.3). Among HPV-positive OPC patients, those with prior LPD had lower 5-year OS (58 %) than typically reported in immunocompetent cohorts. HPV-positive OPC patients with previous LPD diagnosis tended to have shorter OS after OPC diagnosis than those diagnosed with LPD after OPC (HR = 1.9, 95 %CI = 0.6-5.4).
CONCLUSIONS: A prior LPD diagnosis influences treatment strategies and may impact survival in patients with OPC. While HPV-positive status remains a favorable prognostic factor, long-term outcomes appear diminished in this population.
METHODS: We conducted a retrospective study of patients evaluated at Dana-Farber Cancer Institute from 2001 to 2020 with diagnoses of both OPC and LPD (leukemia or lymphoma). Demographic and clinical data were compared by order of diagnosis, and overall survival (OS) from OPC diagnosis was analyzed.
RESULTS: Among 53 patients, 38 % were diagnosed with OPC first and 62 % with LPD first. Median ages at OPC and LPD diagnoses were 62 and 61 years, respectively. Fiftyseven percent of OPCs were HPV-positive. Patients with prior LPD were more likely to undergo surgery (51 % vs 30 %) and less likely to receive radiation (66 % vs 100 %) for OPC (p = 0.03), despite similar disease stage. Patients with HPV-negative OPC had significantly worse OS than those with HPV-positive tumors (HR 5.6, 95 %CI2.2-14.3). Among HPV-positive OPC patients, those with prior LPD had lower 5-year OS (58 %) than typically reported in immunocompetent cohorts. HPV-positive OPC patients with previous LPD diagnosis tended to have shorter OS after OPC diagnosis than those diagnosed with LPD after OPC (HR = 1.9, 95 %CI = 0.6-5.4).
CONCLUSIONS: A prior LPD diagnosis influences treatment strategies and may impact survival in patients with OPC. While HPV-positive status remains a favorable prognostic factor, long-term outcomes appear diminished in this population.