Oropharyngeal squamous cell carcinoma in the veteran population: Association with traditional carcinogen exposure and poor clinical outcomes
Background A significant fraction of oropharyngeal squamous cell carcinoma (SCC) cases is associated with traditional carcinogens; in these patients, treatment response and clinical outcomes remain poor. Methods We evaluated patient, tumor, and treatment characteristics for 200 veterans with orophar...
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| Veröffentlicht in: | Head & neck 2015-09, Vol.37 (9), p.1246-1253 |
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| creator | Sandulache, Vlad C. Hamblin, John Lai, Syeling Pezzi, Todd Skinner, Heath D. Khan, Numan A. Dioun, Shayan M. Hartman, Christine Kramer, Jennifer Chiao, Elizabeth Zhou, Xiaodong Zevallos, Jose P. |
| description | Background
A significant fraction of oropharyngeal squamous cell carcinoma (SCC) cases is associated with traditional carcinogens; in these patients, treatment response and clinical outcomes remain poor.
Methods
We evaluated patient, tumor, and treatment characteristics for 200 veterans with oropharyngeal SCC treated at the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) between 2000 and 2012.
Results
Most patients (77%) were white and heavy smokers. Twenty‐seven patients required tracheostomy and 63 required gastrostomy placement during treatment. Overall survival (OS) at 5 years was 40%. Survival was impacted by T classification, treatment intensity, completion of treatment, and p16 tumor status. Almost 30% of patients were unable to complete a treatment regimen consistent with National Comprehensive Cancer Network (NCCN) guidelines.
Conclusion
Oropharyngeal SCC in veterans is associated with traditional carcinogens and poor clinical outcomes. Despite heavy smoking exposure, p16 tumor status significantly impacts survival. Careful consideration must be given to improving treatment paradigms for this cohort given their limited tolerance for treatment escalation. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1246–1253, 2015 |
| doi_str_mv | 10.1002/hed.23740 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_journals_1702835952</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3773468061</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3920-2b750126e459310c284833f331dbb7981fdac0aab12e5d41eda9be851156cbf43</originalsourceid><addsrcrecordid>eNo9kclO5DAQhi3EiP0wLzCyxDlQXhIn3BDrIDRIrBIXy3GqaUMSBztheYd5aNLd0KeqUn3_r1L9hPxmsMcA-P4Uqz0ulIQVssGgUAkIqVZnvRSJACXXyWaMzwAgMsnXyDqXOTAG2Qb5fxV8NzXhs31CU9P4OpjGD5FarGtqTbCu9Y2hrqX9FOkb9hhMSzvfDbXpnW8P6GGM3rr5QN9dP6V9MJWbjWbp8IQtxY_OxyEgNW01GvhAbe1aZ0fKD731DcZt8mti6og733WL3J2e3B6dJ5dXZ3-PDi8TKwoOCS9VCoxnKNNCMLA8l7kQEyFYVZaqyNmkMhaMKRnHtJIMK1OUmKeMpZktJ1Jskd2Fbxf864Cx189-COO9UTMFPBdpkfKR-vNNDWWDle6Ca8ZH6Z_njcD-Anh3NX4u9wz0LBU9pqLnqejzk-N5MyqShcLFHj-WChNedKaESvXDvzN98Xiq4OZa6HvxBZHFkNc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1702835952</pqid></control><display><type>article</type><title>Oropharyngeal squamous cell carcinoma in the veteran population: Association with traditional carcinogen exposure and poor clinical outcomes</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Sandulache, Vlad C. ; Hamblin, John ; Lai, Syeling ; Pezzi, Todd ; Skinner, Heath D. ; Khan, Numan A. ; Dioun, Shayan M. ; Hartman, Christine ; Kramer, Jennifer ; Chiao, Elizabeth ; Zhou, Xiaodong ; Zevallos, Jose P.</creator><creatorcontrib>Sandulache, Vlad C. ; Hamblin, John ; Lai, Syeling ; Pezzi, Todd ; Skinner, Heath D. ; Khan, Numan A. ; Dioun, Shayan M. ; Hartman, Christine ; Kramer, Jennifer ; Chiao, Elizabeth ; Zhou, Xiaodong ; Zevallos, Jose P.</creatorcontrib><description>Background
A significant fraction of oropharyngeal squamous cell carcinoma (SCC) cases is associated with traditional carcinogens; in these patients, treatment response and clinical outcomes remain poor.
Methods
We evaluated patient, tumor, and treatment characteristics for 200 veterans with oropharyngeal SCC treated at the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) between 2000 and 2012.
Results
Most patients (77%) were white and heavy smokers. Twenty‐seven patients required tracheostomy and 63 required gastrostomy placement during treatment. Overall survival (OS) at 5 years was 40%. Survival was impacted by T classification, treatment intensity, completion of treatment, and p16 tumor status. Almost 30% of patients were unable to complete a treatment regimen consistent with National Comprehensive Cancer Network (NCCN) guidelines.
Conclusion
Oropharyngeal SCC in veterans is associated with traditional carcinogens and poor clinical outcomes. Despite heavy smoking exposure, p16 tumor status significantly impacts survival. Careful consideration must be given to improving treatment paradigms for this cohort given their limited tolerance for treatment escalation. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1246–1253, 2015</description><identifier>ISSN: 1043-3074</identifier><identifier>EISSN: 1097-0347</identifier><identifier>DOI: 10.1002/hed.23740</identifier><identifier>PMID: 24801106</identifier><identifier>CODEN: HEANEE</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Alcoholism - complications ; Carcinogens ; Carcinoma, Squamous Cell - etiology ; Carcinoma, Squamous Cell - mortality ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - therapy ; Chemoradiotherapy - methods ; Cohort Studies ; Disease-Free Survival ; gastrostomy ; Hospitals, Veterans ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Invasiveness - pathology ; Neoplasm Recurrence, Local - mortality ; Neoplasm Recurrence, Local - physiopathology ; Neoplasm Recurrence, Local - therapy ; Neoplasm Staging ; oropharyngeal cancer ; Oropharyngeal Neoplasms - etiology ; Oropharyngeal Neoplasms - mortality ; Oropharyngeal Neoplasms - pathology ; Oropharyngeal Neoplasms - therapy ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Assessment ; smoking ; Smoking - adverse effects ; Survival Analysis ; tracheostomy ; veteran ; Veterans - statistics & numerical data</subject><ispartof>Head & neck, 2015-09, Vol.37 (9), p.1246-1253</ispartof><rights>2014 Wiley Periodicals, Inc.</rights><rights>2015 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3920-2b750126e459310c284833f331dbb7981fdac0aab12e5d41eda9be851156cbf43</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhed.23740$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhed.23740$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,782,786,1419,27931,27932,45581,45582</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24801106$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sandulache, Vlad C.</creatorcontrib><creatorcontrib>Hamblin, John</creatorcontrib><creatorcontrib>Lai, Syeling</creatorcontrib><creatorcontrib>Pezzi, Todd</creatorcontrib><creatorcontrib>Skinner, Heath D.</creatorcontrib><creatorcontrib>Khan, Numan A.</creatorcontrib><creatorcontrib>Dioun, Shayan M.</creatorcontrib><creatorcontrib>Hartman, Christine</creatorcontrib><creatorcontrib>Kramer, Jennifer</creatorcontrib><creatorcontrib>Chiao, Elizabeth</creatorcontrib><creatorcontrib>Zhou, Xiaodong</creatorcontrib><creatorcontrib>Zevallos, Jose P.</creatorcontrib><title>Oropharyngeal squamous cell carcinoma in the veteran population: Association with traditional carcinogen exposure and poor clinical outcomes</title><title>Head & neck</title><addtitle>Head Neck</addtitle><description>Background
A significant fraction of oropharyngeal squamous cell carcinoma (SCC) cases is associated with traditional carcinogens; in these patients, treatment response and clinical outcomes remain poor.
Methods
We evaluated patient, tumor, and treatment characteristics for 200 veterans with oropharyngeal SCC treated at the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) between 2000 and 2012.
Results
Most patients (77%) were white and heavy smokers. Twenty‐seven patients required tracheostomy and 63 required gastrostomy placement during treatment. Overall survival (OS) at 5 years was 40%. Survival was impacted by T classification, treatment intensity, completion of treatment, and p16 tumor status. Almost 30% of patients were unable to complete a treatment regimen consistent with National Comprehensive Cancer Network (NCCN) guidelines.
Conclusion
Oropharyngeal SCC in veterans is associated with traditional carcinogens and poor clinical outcomes. Despite heavy smoking exposure, p16 tumor status significantly impacts survival. Careful consideration must be given to improving treatment paradigms for this cohort given their limited tolerance for treatment escalation. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1246–1253, 2015</description><subject>Adult</subject><subject>Aged</subject><subject>Alcoholism - complications</subject><subject>Carcinogens</subject><subject>Carcinoma, Squamous Cell - etiology</subject><subject>Carcinoma, Squamous Cell - mortality</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - therapy</subject><subject>Chemoradiotherapy - methods</subject><subject>Cohort Studies</subject><subject>Disease-Free Survival</subject><subject>gastrostomy</subject><subject>Hospitals, Veterans</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neoplasm Invasiveness - pathology</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Recurrence, Local - physiopathology</subject><subject>Neoplasm Recurrence, Local - therapy</subject><subject>Neoplasm Staging</subject><subject>oropharyngeal cancer</subject><subject>Oropharyngeal Neoplasms - etiology</subject><subject>Oropharyngeal Neoplasms - mortality</subject><subject>Oropharyngeal Neoplasms - pathology</subject><subject>Oropharyngeal Neoplasms - therapy</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>smoking</subject><subject>Smoking - adverse effects</subject><subject>Survival Analysis</subject><subject>tracheostomy</subject><subject>veteran</subject><subject>Veterans - statistics & numerical data</subject><issn>1043-3074</issn><issn>1097-0347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kclO5DAQhi3EiP0wLzCyxDlQXhIn3BDrIDRIrBIXy3GqaUMSBztheYd5aNLd0KeqUn3_r1L9hPxmsMcA-P4Uqz0ulIQVssGgUAkIqVZnvRSJACXXyWaMzwAgMsnXyDqXOTAG2Qb5fxV8NzXhs31CU9P4OpjGD5FarGtqTbCu9Y2hrqX9FOkb9hhMSzvfDbXpnW8P6GGM3rr5QN9dP6V9MJWbjWbp8IQtxY_OxyEgNW01GvhAbe1aZ0fKD731DcZt8mti6og733WL3J2e3B6dJ5dXZ3-PDi8TKwoOCS9VCoxnKNNCMLA8l7kQEyFYVZaqyNmkMhaMKRnHtJIMK1OUmKeMpZktJ1Jskd2Fbxf864Cx189-COO9UTMFPBdpkfKR-vNNDWWDle6Ca8ZH6Z_njcD-Anh3NX4u9wz0LBU9pqLnqejzk-N5MyqShcLFHj-WChNedKaESvXDvzN98Xiq4OZa6HvxBZHFkNc</recordid><startdate>201509</startdate><enddate>201509</enddate><creator>Sandulache, Vlad C.</creator><creator>Hamblin, John</creator><creator>Lai, Syeling</creator><creator>Pezzi, Todd</creator><creator>Skinner, Heath D.</creator><creator>Khan, Numan A.</creator><creator>Dioun, Shayan M.</creator><creator>Hartman, Christine</creator><creator>Kramer, Jennifer</creator><creator>Chiao, Elizabeth</creator><creator>Zhou, Xiaodong</creator><creator>Zevallos, Jose P.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope></search><sort><creationdate>201509</creationdate><title>Oropharyngeal squamous cell carcinoma in the veteran population: Association with traditional carcinogen exposure and poor clinical outcomes</title><author>Sandulache, Vlad C. ; Hamblin, John ; Lai, Syeling ; Pezzi, Todd ; Skinner, Heath D. ; Khan, Numan A. ; Dioun, Shayan M. ; Hartman, Christine ; Kramer, Jennifer ; Chiao, Elizabeth ; Zhou, Xiaodong ; Zevallos, Jose P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3920-2b750126e459310c284833f331dbb7981fdac0aab12e5d41eda9be851156cbf43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Alcoholism - complications</topic><topic>Carcinogens</topic><topic>Carcinoma, Squamous Cell - etiology</topic><topic>Carcinoma, Squamous Cell - mortality</topic><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Carcinoma, Squamous Cell - therapy</topic><topic>Chemoradiotherapy - methods</topic><topic>Cohort Studies</topic><topic>Disease-Free Survival</topic><topic>gastrostomy</topic><topic>Hospitals, Veterans</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neoplasm Invasiveness - pathology</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Recurrence, Local - physiopathology</topic><topic>Neoplasm Recurrence, Local - therapy</topic><topic>Neoplasm Staging</topic><topic>oropharyngeal cancer</topic><topic>Oropharyngeal Neoplasms - etiology</topic><topic>Oropharyngeal Neoplasms - mortality</topic><topic>Oropharyngeal Neoplasms - pathology</topic><topic>Oropharyngeal Neoplasms - therapy</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>smoking</topic><topic>Smoking - adverse effects</topic><topic>Survival Analysis</topic><topic>tracheostomy</topic><topic>veteran</topic><topic>Veterans - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sandulache, Vlad C.</creatorcontrib><creatorcontrib>Hamblin, John</creatorcontrib><creatorcontrib>Lai, Syeling</creatorcontrib><creatorcontrib>Pezzi, Todd</creatorcontrib><creatorcontrib>Skinner, Heath D.</creatorcontrib><creatorcontrib>Khan, Numan A.</creatorcontrib><creatorcontrib>Dioun, Shayan M.</creatorcontrib><creatorcontrib>Hartman, Christine</creatorcontrib><creatorcontrib>Kramer, Jennifer</creatorcontrib><creatorcontrib>Chiao, Elizabeth</creatorcontrib><creatorcontrib>Zhou, Xiaodong</creatorcontrib><creatorcontrib>Zevallos, Jose P.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Head & neck</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sandulache, Vlad C.</au><au>Hamblin, John</au><au>Lai, Syeling</au><au>Pezzi, Todd</au><au>Skinner, Heath D.</au><au>Khan, Numan A.</au><au>Dioun, Shayan M.</au><au>Hartman, Christine</au><au>Kramer, Jennifer</au><au>Chiao, Elizabeth</au><au>Zhou, Xiaodong</au><au>Zevallos, Jose P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Oropharyngeal squamous cell carcinoma in the veteran population: Association with traditional carcinogen exposure and poor clinical outcomes</atitle><jtitle>Head & neck</jtitle><addtitle>Head Neck</addtitle><date>2015-09</date><risdate>2015</risdate><volume>37</volume><issue>9</issue><spage>1246</spage><epage>1253</epage><pages>1246-1253</pages><issn>1043-3074</issn><eissn>1097-0347</eissn><coden>HEANEE</coden><abstract>Background
A significant fraction of oropharyngeal squamous cell carcinoma (SCC) cases is associated with traditional carcinogens; in these patients, treatment response and clinical outcomes remain poor.
Methods
We evaluated patient, tumor, and treatment characteristics for 200 veterans with oropharyngeal SCC treated at the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) between 2000 and 2012.
Results
Most patients (77%) were white and heavy smokers. Twenty‐seven patients required tracheostomy and 63 required gastrostomy placement during treatment. Overall survival (OS) at 5 years was 40%. Survival was impacted by T classification, treatment intensity, completion of treatment, and p16 tumor status. Almost 30% of patients were unable to complete a treatment regimen consistent with National Comprehensive Cancer Network (NCCN) guidelines.
Conclusion
Oropharyngeal SCC in veterans is associated with traditional carcinogens and poor clinical outcomes. Despite heavy smoking exposure, p16 tumor status significantly impacts survival. Careful consideration must be given to improving treatment paradigms for this cohort given their limited tolerance for treatment escalation. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1246–1253, 2015</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>24801106</pmid><doi>10.1002/hed.23740</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Alcoholism - complications Carcinogens Carcinoma, Squamous Cell - etiology Carcinoma, Squamous Cell - mortality Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - therapy Chemoradiotherapy - methods Cohort Studies Disease-Free Survival gastrostomy Hospitals, Veterans Humans Kaplan-Meier Estimate Male Middle Aged Multivariate Analysis Neoplasm Invasiveness - pathology Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - physiopathology Neoplasm Recurrence, Local - therapy Neoplasm Staging oropharyngeal cancer Oropharyngeal Neoplasms - etiology Oropharyngeal Neoplasms - mortality Oropharyngeal Neoplasms - pathology Oropharyngeal Neoplasms - therapy Prognosis Proportional Hazards Models Retrospective Studies Risk Assessment smoking Smoking - adverse effects Survival Analysis tracheostomy veteran Veterans - statistics & numerical data |
| title | Oropharyngeal squamous cell carcinoma in the veteran population: Association with traditional carcinogen exposure and poor clinical outcomes |
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