Oropharyngeal cancer diagnosis and treatment in actual clinical practice in the Republic of Bashkortostan: analysis for 2020
https://doi.org/10.24060/2076-3093-2022-12-4-267-274
Abstract
Introduction. Th e growing incidence of oropharyngeal cancer is driven by an increase in frequency of HPV-associated oropharyngeal cancer. Th e morbidity pattern of oropharyngeal cancer is area-specific.
Aim. To analyze the oropharyngeal cancer diagnosis and treatment in the Republic of Bashkortostan for 2020.
Materials and methods. Th e authors carried out a 2020 retrospective analysis of the diagnosis and treatment results of patients with oropharyngeal cancer. 79 patients were identified with this diagnosis. 84.8% (67/79) among them were males and 15.2% females (12/79). Th e mean age of the patients was 59.1 years. Th e site of primary tumor was on the oropharynx lateral wall in 37.8% cases (30/79), in the tongue root area — 24.1% (19/79), in the tonsils area — 17.7% (14/79), on the soft palate — 16.5% (13/79), on the oropharynx posterior wall — 3.8% (3/79).
Results. Examination of tumor morphological types revealed squamous cell carcinoma (SCC) with various degrees of differentiation in 92.4% cases (73/79), adenocarcinoma of minor salivary gland — in 6.3% (5/79) and sarcoma in 1.2% (1/79). 57.5% of 73 patients with SCC (42/73) underwent protein (p16) immunohistochemistry, while 42.5% of the patients (31/73) did not. According to a surrogate marker for HPV, the following results were obtained for 42 patients: p16-positive in 23.8% cases (10/42), p16-negative in 76.2% (32/42). Stage distribution according to TNM-7: stage I — 11.4% (9/79), stage II — 17.7% (14/79), stage III — 36.7% (29/79), stage IV — 46.8% (37/79). Stage distribution according to TNM-8 (patients who underwent p16 immunohistochemistry): stage I — 11.9% (5/42), stage II — 23.8% (10/42), stage III — 19% (8/42), stage IV — 45.2% (19/42). In 2020, 72% of patients (57/79) received definitive treatment, 10.1% (8/79) — palliative care, 15.2% (12/79) — supportive care, and 2.5% (2/79) refused medical treatment.
Discussion. Th e various types of radiation therapy were used as the main defi nitive treatment for patients with oropharyngeal cancer in 69.2% cases (45/65). Only 18.5% of patients (12/65) underwent surgery, 58.3% of which (7/12) received post-surgery radiation therapy.
Conclusion. 57.5% of patients (42/73) were detected with HPV status, 23.8% (10/42) revealed surrogate markers for HPV association. 69.2% of patients (45/65) received radiation therapy as the definitive treatment. 18.5% of patients (12/65) underwent surgery, 58.3% of which (7/12) received postsurgery radiation therapy.
About the Authors
Sh. I. MusinRussian Federation
Shamil I. Musin — Cand. Sci. (Med.), Surgery Unit No. 6,
Department of Oncology with Courses of Oncology and Pathological Anatomy for Advanced Professional Education
Ufa
A. V. Sultanbaev
Russian Federation
Alexander V. Sultanbaev — Cand. Sci. (Med.), Anticancer Drug Therapy Unit
Ufa
K. V. Menshikov
Russian Federation
Konstantin V. Menshikov — Cand. Sci. (Med.), Assoc. Prof.,
Department of Oncology with Courses of Oncology and
Pathological Anatomy for Advanced Professional Education, Chemotherapy Unit
Ufa
L. K. Zakirova
Russian Federation
Lyalya K. Zakirova — Cand. Sci. (Med.), Organizational and Methodological Unit
Ufa
F. F. Mufazalov
Russian Federation
Fagim F. Mufazalov — Dr. Sci. (Med.), Radiation Oncology UnitUnit
Ufa
I. A. Sharifgaliev
Russian Federation
Ildar A. Sharifgaliev — Anatomical Pathology Unit
Ufa
A. F. Nasretdinov
Russian Federation
Ainur F. Nasretdinov — Outpatient Anticancer Drug Therapy Unit
Ufa
S. V. Osokin
Russian Federation
Sergei V. Osokin — Surgery Unit No. 6
Ufa
N. A. Sharafutdinova
Russian Federation
Nataliya A. Sharafutdinova — Surgery Unit No. 6
Ufa
V. V. Ilyin
Russian Federation
Vasilii V. Ilyin — Surgery Unit No. 6
Ufa
D. O. Lipatov
Russian Federation
Danila O. Lipatov
Ufa
M. V. Sultanbaev
Russian Federation
Mikhail V. Sultanbaev — Cand. Sci. (Med.), Department of Oncology with Courses of Oncology and Pathological Anatomy for Advanced Professional Education
Ufa
T. E. Timin
Russian Federation
Кonstantin E. Timin — Outpatient Oncological Care Center
Oktyabrsky
References
1. Pytynia K.B., Dahlstrom K.R., Sturgis E.M. Epidemiology of HPVassociated oropharyngeal cancer. Oral Oncol. 2014;50(5):380–6. DOI: 10.1016/j.oraloncology.2013.12.019
2. Timbang MR, Sim MW, Bewley AF, Farwell DG, Mantravadi A, Moore MG. HPV-related oropharyngeal cancer: a review on burden of the disease and opportunities for prevention and early detection. Hum Vaccin Immunother. 2019;15(7–8):1920–8. DOI: 10.1080/21645515.2019.1600985
3. Kaprin A.D., Starinsky V.V., Shakhzadova A.O. (ed.) State of cancer care for population in Russia in 2020. Moscow: P.A Gertsen Moscow Research Oncology Institute — branch of the National Medical Research Center for Radiology; 2021 (In Russ.).
4. Mudunov A.M., Choinzonov E.L., Reshetov I.V., et al. Oropharyngeal cancer: clinical guidelines. Moscow; 2020 (In Russ.).
5. Machczyński P., Majchrzak E., Niewinski P., Marchlewska J., Golusiński W. A review of the 8th edition of the AJCC staging system for oropharyngeal cancer according to HPV status. Eur Arch Otorhinolaryngol. 2020;277(9):2407–12. DOI: 10.1007/s00405-020-05979-9
6. Mehanna H., Beech T., Nicholson T., El-Hariry I., McConkey C., Paleri V., et al. Prevalence of human papillomavirus in oropharyngeal and nonoropharyngeal head and neck cancer--systematic review and meta-analysis of trends by time and region. Head Neck. 2013;35(5):747–55. DOI: 10.1002/hed.22015
7. Karpenko A.V., Sibgatullin R.R., Boyko A.A., Vorob’ev S.L., Korablina I.M., Nikolayeva O.M., et al. Th e incidence and prognosis of HPVpositive oropharyngeal cancer. P.A. Herzen Journal of Oncology. 2019;8(1):20–5 (In Russ.) DOI: 10.17116/onkolog2019801120
8. Stukan A.I., Chukhray O.Yu., Porkhanov V.A., Murashko R.A., Bodnya V.N., Elizbaryan I.S. Clinical, morphological, and prognostic features of head and neck squamous cell carcinoma associated with human papillomavirus. P.A. Herzen Journal of Oncology. 2019;8(1):13–9 (In Russ.). DOI: 10.17116/onkolog2019801113
9. Pkheshkhova B.G., Mudunov A.M., Azizyan R.I., Pak M.B., Ishchenko K.B. Estimation of the prevalence of HPV-positive squamous cell carcinoma of the oropharynx on the example of a separate sample in the Russian Federation. Head and Neck Tumors (HNT). 2022;12(1):72–8 (In Russ.). DOI: 10.17650/2222-1468-2022-12-1-72-78
10. Nauta I.H., Riebergen M.M., van Bokhoven A.A.J.D., Bloemena E., Lissenberg-Witte B.I., Heideman D.A.M., et al. Evaluation of the eighth TNM classifi cation on p16-positive oropharyngeal squamous cell carcinomas in the Netherlands and the importance of additional HPV DNA testing. Ann Oncol. 2018;29(5):1273–79. DOI: 10.1093/annonc/mdy060. PMID: 29438466
11. Cancer Genome Atlas Network. Comprehensive genomic characterization of head and neck squamous cell carcinomas. Nature. 2015;517(7536):576–82. DOI: 10.1038/nature14129
12. Yakin M., Seo B., Hussaini H., Rich A., Hunter K. Human papillomavirus and oral and oropharyngeal carcinoma: the essentials. Aust Dent J. 2019;64(1):11–8. DOI: 10.1111/adj.12652
13. Machiels J.P., René Leemans C., Golusinski W., Grau C., Licitra L., Gregoire V. Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS-ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020;31(11):1462–75. DOI: 10.1016/j.annonc.2020.07.011
14. Tawk B., Debus J., Abdollahi A. Evolution of a paradigm switch in diagnosis and treatment of HPV-driven head and neck cancerstriking the balance between toxicity and cure. Front Pharmacol. 2022;12:753387. DOI: 10.3389/fphar.2021.753387
15. Malm I.J., Fan C.J., Yin L.X., Li D.X., Koch W.M., Gourin C.G., et al. Evaluation of proposed staging systems for human papillomavirus- related oropharyngeal squamous cell carcinoma. Cancer. 2017;123(10):1768–77. DOI: 10.1002/cncr.30512
16. Nichols A.C., Th eurer J., Prisman E. Radiotherapy versus transoral robotic surgery and neck dissection for oropharyngeal squamous cell carcinoma (ORATOR): an open-label, phase 2, randomised trial. Lancet Oncol. 2019;20(10):1349–59. DOI: 10.1016/S1470-2045(19)30410-3
17. Tiedemann D., Jakobsen K.K., von Buchwald C., Grønhøj C. Systematic review on location and timing of distant progression in human papillomavirus-positive and human papillomavirus-negative oropharyngeal squamous cell carcinomas. Head Neck. 2019;41(3):793–8. DOI: 10.1002/hed.25458
Review
For citations:
Musin Sh.I., Sultanbaev A.V., Menshikov K.V., Zakirova L.K., Mufazalov F.F., Sharifgaliev I.A., Nasretdinov A.F., Osokin S.V., Sharafutdinova N.A., Ilyin V.V., Lipatov D.O., Sultanbaev M.V., Timin T.E. Oropharyngeal cancer diagnosis and treatment in actual clinical practice in the Republic of Bashkortostan: analysis for 2020. Creative surgery and oncology. 2022;12(4):267-274. (In Russ.) https://doi.org/10.24060/2076-3093-2022-12-4-267-274