Sterberisiko für Mundhöhlen- und Oropharynxkarzinome in Thüringen: eine bevölkerungsbasierte Analyse

Zusammenfassung

Hintergrund Diese populationsbezogene Studie untersuchte den Einfluss der HPV-Assoziation auf das Gesamtüberleben (OS) von Mundhöhlen- (OSCC) und Oropharynxkarzinomen (OPSCC) in Thüringen und die Inzidenz der HPV-positiven (HPV+) und HPV-negativen (HPV-) Tumoren.

Methoden Insgesamt wurden alle 308 Thüringer Patienten (83,4 % Männer; medianes Alter 58 Jahre) mit der Erstdiagnose eines OSCC (38%) oder OPSCC (62%) aus dem Jahr 2008 in die Studie aufgenommen. Nach der Risikoklassifikation nach Ang wurden Patienten in ein geringes Sterberisiko (HPV+, Nichtraucher), intermediäres Risiko (HPV+, Raucher) und hohem Sterberisiko (HPV-, Raucher) eingeteilt. Kaplan-Meier-Analysen und eine multivariable Regressionsanalyse nach Cox wurden durchgeführt, um das OS zu untersuchen.

Ergebnisse 22,5% der OPSCC war HPV+ (davon 80,1% Raucher; Inzidenz: 1,89/100.000 Einwohner). Bei OSCC lag der Anteil der HPV+ bei 8,5% (davon 78,6% Raucher; Inzidenz: 0,44/100.000). Der mediane Follow-up betrug 31 Monate. HPV+ Patienten hatten eine signifikant bessere 5-Jahres-OS als HPV-Patienten (81 % vs. 49 %; p < 0,001). In der multivariablen Analyse ergab sich ein höheres Sterberisiko für: HPV-Patienten (Hazard Ratio [HR] = 3,2; 95%-Konfidenzintervall [KI]: 1,6–6,4; p = 0,001), eine hohe Risikoklasse nach Ang (HR = 2,3; 95%-KI: 1,0–5,4; p = 0,049), höheres Alter (HR = 1,7; 95%-KI = 1,1–2,4; p = 0,01), T3/T4 Tumoren (HR = 2,1; 95%-KI = 1,3–3,2; p = 0,001) und das Vorhandensein von Fernmetastasen (HR = 2,7; 95%-KI = 1,6–4,4; p < 0,001).

Schlussfolgerung HPV+ Nichtraucher waren in Thüringen eine Minderheit. Die Mehrheit der HPV+ Patienten in Thüringen wiesen durch den Nikotinkonsum als Risikofaktor ein intermediäres Sterberisiko auf.

Abstract

Objective This population-based study investigates the impact of HPV association on overall survival (OS) of oral cavity (OSCC) and oropharyngeal squamous cell carcinoma (OPSCC) in Thuringia and the incidence of HPV-positive (HPV+) and HPV-negative (HPV-) tumors.

Methods A total of 308 patients (83.4% men; mean age 57.6 years) with a primary diagnosis of OSCC (38%) or OPSCC (62%) from 2008 were included in the study. Descriptive statistics were obtained for the variables. According to Angʼs risk classification, patients were classified as low risk of death (HPV+, nonsmokers), intermediate risk (HPV+, smokers) and high risk of death (HPV-smokers). Kaplan-Meier analyses and Cox multivariable regression analysis were performed to examine OS.

Results 22.5% of OPSCC was HPV+ (incidence: 1.89/100,000 population; thereof 80.1% smokers). The proportion of OSCC with HPV+ was 8.5% (incidence: 0.44/100,000; thereof 78.6% smokers). The median follow-up was 31 months. HPV+ patients had significantly better 5-year OS than HPV- patients (81% vs. 49%; p < 0.001). In multivariable analysis lower OS were associated with: HPV-patients (hazard ratio (HR) = 3.2; 95% confidence interval (CI) = 1.6–6.4; p = 0.001), high risk of death according to Ang (HR = 2.3; 95% CI = 1.0–5.4; p = 0.049), older age (HR = 1.7; 95% CI = 1.1–2.4; p = 0.01), T3/T4-classification (HR = 2.1; 95% CI = 1.3–3.2; p = 0.001) and the presence of distant metastases (HR = 2.7; 95% CI = 1.6–4.4; p < 0.001).

Conclusions HPV+ non-smokers were minority in Thuringia. The majority of HPV+ patients had an intermediate risk of death due to cigarette smoking.

Schlüsselwörter

Humanes Papillomavirus - Kopf-Hals-Tumoren - Risikostratifizierung - Rauchen - Alkohol - Überleben - Inzidenz

Keywords

human papillomavirus - head and neck cancer - risk stratification - smoking - overall survival - incidence

Publication History

Received: 23 August 2022

Accepted after revision: 10 November 2022

Article published online:
05 January 2023

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