Synchronous primary neoplasia in patients with oropharyngeal cancer: Impact of tumor HPV status. A GETTEC multicentric study

Florent Milliet (1) , Alexandre Bozec (2) , Renaud Schiappa (2) , Julien Viotti (2) , Anouchka Modesto (3) , Olivier Dassonville (2) , Gilles Poissonnet (2) , Bruno Guelfucci (4) , Alain Bizeau (4) , Sebastien Vergez (3) , Agnes Dupret-Bories (3) , Renaud Garrel (5) , Nicolas Fakhry (6) , Laure Santini (6) , Benjamin Lallemant (7) , Guillaume Chambon (7) , Anne Sudaka (2) , Frederic Peyrade (2) , Esma Saada-Bouzid (2) , Karen Benezery (2) , Florence Jourdan-Soulier (4) , Françoise Chapel (4) , Anne Sophie Ramay (7) , Pascal Roger (7) , Thibault Galissier (3) , Valérie Coste (8) , Aicha Ben Lakdar (9) , Joanne Guerlain (9, 10) , Stephane Temam (9, 10) , Haitham Mirghani (11) , Phillipe Gorphe (9, 10) , Emmanuel Chamorey (2) , Dorian Culié (2)

1 CHU Nice - Centre Hospitalier Universitaire de Nice
2 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
3 IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole
4 Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer - Hôpital Sainte-Musse
5 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
6 APHM - Assistance Publique - Hôpitaux de Marseille
7 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
8 Pôle Biologie-Pathologie [CHRU Montpellier]
9 IGR - Institut Gustave Roussy
10 CCF - Département de cancérologie cervico-faciale [Gustave Roussy]
11 HEGP - Hôpital Européen Georges Pompidou [APHP]

Patients with oropharyngeal squamous cell carcinoma (OPSCC) display a significant risk of synchronous primary neoplasia (SPN) which could impact their management. The aims of this study were to evaluate the risk and distribution of SPN in OPSCC patients according to their HPV (p16) status, the predictive factors of SPN and the impact of SPN on therapeutic strategy and oncologic outcomes. Material and methods: All OPSCC patients treated from 2009 to 2014 were included in this multicentric retrospective study. Univariate analyses were conducted using Chi-2 and Fisher exact tests. For multivariate analyses, all variables associated with a p ≤ 0.10 in univariate analysis were included in logistic regression models. Results: Among the 1291 patients included in this study, 75 (5.8%) displayed a SPN which was preferentially located in the upper aerodigestive tract, lung and esophagus. Comorbidity level (p = 0.03), alcohol (p = 0.005) and tobacco (p = 0.01) consumptions, and p16 tumor status (p < 0.0001) were significant predictors of SPN. In multivariate analysis, p16+ status was significantly associated with a lower risk of SPN (OR = 0.251, IC95% [0.133;0.474]). Patients with a SPN were more frequently referred for non-curative treatment (p = 0.02). In patients treated with curative intent, there was no impact of SPN on the therapeutic strategy (surgical vs. non-surgical treatment). We observed no overall survival differences between patients with or without SPN. Conclusion: P16 tumor status is the main predictive factor of SPN in OPSCC patients. This study provides crucial results which should help adapt the initial work-up and the global management of OPSCC patients.

Mots clés: Cancer; Human papilloma virus; Oropharynx; Second primary neoplasia

Domaines: Cancer

Florent Milliet, Alexandre Bozec, Renaud Schiappa, Julien Viotti, Anouchka Modesto, et al.. Synchronous primary neoplasia in patients with oropharyngeal cancer: Impact of tumor HPV status. A GETTEC multicentric study. Oral Oncology, 2021, 112, pp.105041. ⟨10.1016/j.oraloncology.2020.105041⟩. ⟨hal-03617423⟩