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A predictive survival model for patients with stage IV oropharyngeal squamous cell carcinoma treated with chemoradiation

  • Head and Neck
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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the pre-treatment and post-treatment clinical factors associated with rate of survival at 1, 3, and 5 years in stage IV oropharyngeal cancer patients treated with concurrent chemoradiation with/without neoadjuvant chemotherapy.

Methods

This retrospective cohort study involved 128 Stage IV oropharyngeal cancer patients that were treated at our tertiary referral center between 2008 and 2020. The pre-treatment and post-treatment clinical parameters including nutritional status and inflammatory markers were retrospectively reviewed.

Results

The 5-year overall survival rate for all patients was 36.72%. The disease-specific survival (DSS) at 1-year and 3-year were 80% and 63%, whereas the disease-free survival (DFS) at 1-year and 3-year were 49% and 40%, respectively. In multivariate analyses, pretreatment hemoglobin (Hb) < 12 g/dL (hazard ratio [HR] 2.551, 95% confidence interval [CI] 1.366–4.762, p = 0.003), pretreatment systemic immune inflammation (SII) ≥ 1751 (HR 2.173, 95% CI 1.015–4.652, p = 0.046), and posttreatment systemic inflammation response index (SIRI) ≥ 261 (HR 2.074, 95% CI 1.045–4.115, p = 0.037) were independent indicators for worsened DSS. Pretreatment Hb < 12 g/dl (HR 1.692, 95% CI 1.019–2.809, p = 0.032), pretreatment SII ≥ 1751 (HR 1.968, 95% CI 1.061–3.650, p = 0.032), and posttreatment SII ≥ 1690 (HR 1.922, 95% CI 1.105–3.345, p = 0.021) were independent indicators for worsened DFS. A nomogram was developed using pretreatment Hb, pretreatment SII, and posttreatment SIRI to forecast DSS.

Conclusions

The pretreatment Hb, pretreatment SII, posttreatment SII, and posttreatment SIRI are associated with survival in patients with stage IV oropharyngeal cancers. The developed nomogram aids in survival prediction and treatment adjustment.

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Data availability

The data produced and analyzed throughout the study can be obtained from the corresponding author of the study upon a reasonable request.

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Acknowledgements

The authors thank the patients for their participation in the study.

Funding

This study was supported by grants of Far Eastern Memorial Hospital (FEMH-2023-C-030), Taiwan.

Author information

Authors and Affiliations

  1. Department of Otolaryngology, Far Eastern Memorial Hospital, 21, Section 2, Nan-Ya South Road, Pan Chiao District, 220, New Taipei City, Taiwan

    Peng Yeh, Chih-Ming Chang, Li-Jen Liao, Po-Wen Cheng & Wu-Chia Lo

  2. Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Chih-Ming Chang

  3. Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan

    Li-Jen Liao, Chia-Yun Wu, Chen-Hsi Hsieh & Wu-Chia Lo

  4. Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan

    Li-Jen Liao

  5. Department of Oncology and Hematology, Far Eastern Memorial Hospital, New Taipei City, Taiwan

    Chia-Yun Wu

  6. Department of Radiology, Division of Radiation Oncology, Far Eastern Memorial Hospital, New Taipei City, Taiwan

    Chen-Hsi Hsieh & Pei-Wei Shueng

  7. Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Chen-Hsi Hsieh & Pei-Wei Shueng

  8. Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan

    Wu-Chia Lo

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Contributions

PY: study concept and design, analysis and interpretation of data, and drafting of the manuscript. C-MC: data collection, analysis and interpretation of data. L-JL: data collection, study concept and design. C-YW: data collection, analysis and interpretation of data. C-HH: data collection, analysis and interpretation of data. P-WS: analysis and interpretation of data. P-WC: data collection, administrative, technical, and material support. W-CL: study concept and design, analysis and interpretation of data, drafting of the manuscript, and critical revision of the manuscript.

Corresponding author

Correspondence to Wu-Chia Lo.

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Conflict of interest

The authors declare no conflict of interest.

Ethics approval

The study was approved by the Institutional Review Board (Far Eastern Memorial Hospital 111223-E) in a tertiary hospital. Waiver of informed consent was approved by the Research Ethics Review Committee of Far Eastern Memorial Hospital (No. 111223-E) as this is a retrospective anonymous study. This study complies fully with the Declaration of Helsinki.

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Yeh, P., Chang, CM., Liao, LJ. et al. A predictive survival model for patients with stage IV oropharyngeal squamous cell carcinoma treated with chemoradiation. Eur Arch Otorhinolaryngol 281, 369–377 (2024). https://doi.org/10.1007/s00405-023-08187-3

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  • DOI: https://doi.org/10.1007/s00405-023-08187-3

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