Development and Assessment of a Novel Composite Pathologic Risk Stratification for Surgically Resected Human Papillomavirus-Associated Oropharyngeal Cancer.

摘要: Importance Human papillomavirus–associated (HPV+) oropharyngeal squamous cell carcinoma (OPSCC) is a distinct form of head and neck (HNSCC) with its own American Joint Committee on Cancer staging system. However, pathologic risk stratification for HPV+ OPSCC largely remains based the experience HPV-unassociated HNSCC. Objective To compare survival discrimination traditional both HNSCC derive novel system improved discrimination. Design, Setting, Participants In this retrospective cohort study, we used National Database to identify 15 324 patients diagnosed nonmetastatic between January 1, 2010, December 31, 2013, who were treated upfront surgery dissection. We compared then derived Analyses performed from July 2018, 2019. Exposures Definitive primary surgical resection Main Outcomes Measures Survival systems measured concordance indices. Results This study included (10 779 men 4545 women; mean [SD] age, 59.9 [11.8] years) surgically Separation curves using (5-year overall low-, intermediate-, high-risk groups) 76.2%, 54.5%, 40.9%, respectively. 93.2%, 88.9%, 83.7%, papillomavirus–unassociated had index 0.68, whereas 0.58. A that more closely fits actual rates was derived. The incorporated composite number adverse features. associated an 0.67 OPSCC. Adjuvant treatment radiation not categorized as low according new system, but in intermediate- groups. Conclusions Relevance Traditional shows poor classifies many excellent prognosis high risk. may be