TY - JOUR
T1 - Clinical and Biologic Characteristics and Outcomes in Young and Middle-Aged Patients With Laryngeal Cancer
T2 - A Retrospective Cohort Analysis
AU - Geng, Calvin X.
AU - Tanamal, Priscilla
AU - Arvisais-Anhalt, Simone
AU - Tomasino, Massimo
AU - Gheit, Tarik
AU - Bishop, Justin A.
AU - Palsgrove, Doreen N.
AU - Wang, Ellen
AU - Salley, Jordan R.
AU - Tibbetts, Kathleen M.
AU - Sumer, Baran D.
AU - Tillman, Brittny N.
AU - Day, Andrew T.
N1 - Publisher Copyright:
© American Academy of Otolaryngology–Head and Neck Surgery Foundation 2022.
PY - 2022
Y1 - 2022
N2 - Objective: To describe the clinical and biologic characteristics and outcomes of young and middle-aged (YMA; <65 years) patients according to the presence or absence of traditional risk factors for laryngeal cancer. Study Design: Retrospective cohort analysis. Setting: Single-institution academic medical center. Methods: Patients without a history of clinically significant tobacco use or heavy alcohol use were defined as “nontraditional”: ≤5 pack-years, ≤5 years smoked, ≤14 alcoholic drinks per week, and ≥15-year interval from last tobacco abuse use to diagnosis. Remaining patients were categorized as “traditional.” Select tumor samples were evaluated for bacterial and viral DNA by multiplex polymerase chain reaction. Results: Seventy-eight YMA patients with primary laryngeal squamous cell carcinoma were identified, 23% (n = 18) of whom were nontraditional. Nontraditional patients were younger than traditional patients (median age, 51 vs 59 years; P <.001). Twenty-eight tumors were prospectively tested for human papillomavirus (HPV), and nontraditional patients were more likely to exhibit high-risk HPV (57% vs 5%, P <.01). Among 17 select tumors (nontraditional, n = 8; traditional, n = 9), 35% exhibited HPV16 (nontraditional, 63%; traditional, 11%; P =.05). Other viruses were identified but did not differ according to risk status: herpesviruses (40%) and Merkel cell polyomavirus (7%). Chlamydia, β-HPV, and γ-HPV DNA was not detected in any samples. Median length of follow-up was 42 months. On adjusted analyses, nontraditional patients exhibited nonsignificantly improved overall survival (hazard ratio, 0.24 [95% CI, 0.03-1.82]; P =.17) and disease-free survival (hazard ratio, 0.34 [95% CI, 0.10-1.23]; P =.08) as compared with traditional patients. Conclusion: Almost one-quarter of YMA patients lacked characteristic risk factors for laryngeal squamous cell carcinoma, and their tumors exhibited a higher prevalence of high-risk HPV. The significance of HPV16 and other tumor viruses with outcomes in nontraditional patients should be evaluated further.
AB - Objective: To describe the clinical and biologic characteristics and outcomes of young and middle-aged (YMA; <65 years) patients according to the presence or absence of traditional risk factors for laryngeal cancer. Study Design: Retrospective cohort analysis. Setting: Single-institution academic medical center. Methods: Patients without a history of clinically significant tobacco use or heavy alcohol use were defined as “nontraditional”: ≤5 pack-years, ≤5 years smoked, ≤14 alcoholic drinks per week, and ≥15-year interval from last tobacco abuse use to diagnosis. Remaining patients were categorized as “traditional.” Select tumor samples were evaluated for bacterial and viral DNA by multiplex polymerase chain reaction. Results: Seventy-eight YMA patients with primary laryngeal squamous cell carcinoma were identified, 23% (n = 18) of whom were nontraditional. Nontraditional patients were younger than traditional patients (median age, 51 vs 59 years; P <.001). Twenty-eight tumors were prospectively tested for human papillomavirus (HPV), and nontraditional patients were more likely to exhibit high-risk HPV (57% vs 5%, P <.01). Among 17 select tumors (nontraditional, n = 8; traditional, n = 9), 35% exhibited HPV16 (nontraditional, 63%; traditional, 11%; P =.05). Other viruses were identified but did not differ according to risk status: herpesviruses (40%) and Merkel cell polyomavirus (7%). Chlamydia, β-HPV, and γ-HPV DNA was not detected in any samples. Median length of follow-up was 42 months. On adjusted analyses, nontraditional patients exhibited nonsignificantly improved overall survival (hazard ratio, 0.24 [95% CI, 0.03-1.82]; P =.17) and disease-free survival (hazard ratio, 0.34 [95% CI, 0.10-1.23]; P =.08) as compared with traditional patients. Conclusion: Almost one-quarter of YMA patients lacked characteristic risk factors for laryngeal squamous cell carcinoma, and their tumors exhibited a higher prevalence of high-risk HPV. The significance of HPV16 and other tumor viruses with outcomes in nontraditional patients should be evaluated further.
KW - cancer
KW - HPV
KW - human papillomavirus
KW - laryngeal
KW - larynx
KW - middle-aged
KW - outcomes and survival
KW - risk factors
KW - squamous cell carcinoma
KW - young
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U2 - 10.1177/01945998211073707
DO - 10.1177/01945998211073707
M3 - Article
C2 - 35077266
AN - SCOPUS:85124046381
SN - 0194-5998
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
ER -