Epidemiological and clinical description of patients with oropharyngeal cancer treated in a public oncology referral hospital in Chile

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Abstract

Introduction

The incidence of squamous carcinoma of the oropharynx (OPSCC) has presented an increase worldwide, a fact that occurs along with a phenomenon of epidemiological transition, whose pathogenesis is linked to human papilloma virus (HPV) in a significant part of the cases. Published evidence at the Latin American level is scarce. The present study aims to evaluate the epidemiological and clinical characteristics of patients with oropharyngeal cancer treated in a public oncology reference centre in Chile.

Methodology

A cross-sectional study was carried out. Patients with histological confirmation of OPSCC aged 18 years or older, referred to the National Cancer Institute of Chile between 2012 and 2023 were included. The association with HPV was determined by immunohistochemistry for p16.

Results

178 patients were analysed, most of them in locoregionally advanced stages involving the palatine tonsil. Seventy-seven percent were male, with a median age of 60 years. Sixty-seven percent of patients were positive for p16, with a progressive increase to 85% in the last 2 years of the study. The p16(+) patients were younger and had fewer classical risk factors. Primary treatment was radiotherapy in 94% of patients.

Conclusion

The epidemiological profile of patients with OPSCC treated in a Chilean public oncology referral centre reflects the epidemiological transition observed in developed countries. This change justifies the need to adapt health policies and conduct research that considers the characteristics of this new epidemiological profile.

Related collections

Most cited references 35

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Worldwide trends in incidence rates for oral cavity and oropharyngeal cancers.

Anil Chaturvedi, William F Anderson, Joannie Lortet-Tieulent … (2013)

Human papillomavirus (HPV) has been identified as the cause of the increasing oropharyngeal cancer (OPC) incidence in some countries. To investigate whether this represents a global phenomenon, we evaluated incidence trends for OPCs and oral cavity cancers (OCCs) in 23 countries across four continents. We used data from the Cancer Incidence in Five Continents database Volumes VI to IX (years 1983 to 2002). Using age-period-cohort modeling, incidence trends for OPCs were compared with those of OCCs and lung cancers to delineate the potential role of HPV vis-à-vis smoking on incidence trends. Analyses were country specific and sex specific. OPC incidence significantly increased during 1983 to 2002 predominantly in economically developed countries. Among men, OPC incidence significantly increased in the United States, Australia, Canada, Japan, and Slovakia, despite nonsignificant or significantly decreasing incidence of OCCs. In contrast, among women, in all countries with increasing OPC incidence (Denmark, Estonia, France, the Netherlands, Poland, Slovakia, Switzerland, and United Kingdom), there was a concomitant increase in incidence of OCCs. Although increasing OPC incidence among men was accompanied by decreasing lung cancer incidence, increasing incidence among women was generally accompanied by increasing lung cancer incidence. The magnitude of increase in OPC incidence among men was significantly higher at younger ages (< 60 years) than older ages in the United States, Australia, Canada, Slovakia, Denmark, and United Kingdom. OPC incidence significantly increased during 1983 to 2002 predominantly in developed countries and at younger ages. These results underscore a potential role for HPV infection on increasing OPC incidence, particularly among men.

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HPV-associated oropharyngeal cancer: epidemiology, molecular biology and clinical management

Matt Lechner, Jacklyn Liu, Liam Masterson … (2022)

Human papillomavirus (HPV)-positive (HPV+) oropharyngeal squamous cell carcinoma (OPSCC) has one of the most rapidly increasing incidences of any cancer in high-income countries. The most recent (8th) edition of the UICC/AJCC staging system separates HPV+ OPSCC from its HPV-negative (HPV−) counterpart to account for the improved prognosis seen in the former. Indeed, owing to its improved prognosis and greater prevalence in younger individuals, numerous ongoing trials are examining the potential for treatment de-intensification as a means to improve quality of life while maintaining acceptable survival outcomes. In addition, owing to the distinct biology of HPV+ OPSCCs, targeted therapies and immunotherapies have become an area of particular interest. Importantly, OPSCC is often detected at an advanced stage owing to a lack of symptoms in the early stages; therefore, a need exists to identify and validate possible diagnostic biomarkers to aid in earlier detection. In this Review, we provide a summary of the epidemiology, molecular biology and clinical management of HPV+ OPSCC in an effort to highlight important advances in the field. Ultimately, a need exists for improved understanding of the molecular basis and clinical course of this disease to guide efforts towards early detection and precision care, and to improve patient outcomes.

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Author and article information

Journal

Journal ID (nlm-ta): Ecancermedicalscience

Journal ID (iso-abbrev): Ecancermedicalscience

Journal ID (publisher-id): ecancermedicalscience

Title: ecancermedicalscience

Publisher: Cancer Intelligence

ISSN (Electronic): 1754-6605

Publication date Collection: 2024

Publication date (Electronic): 26 March 2024

Volume: 18

Electronic Location Identifier: 1685

Affiliations

[1 ]Department of Radiotherapy, National Cancer Institute, Santiago 8380000, Chile

[2 ]Department of Radiotherapy, Hospital Base Valdivia, Los Ríos 5090145, Chile

[3 ]Department of Basic Clinical Oncology, School of Medicine, Universidad de Chile, Santiago 8380453, Chile

[4 ]Department of Otolaryngology, School of Medicine, Universidad de Chile, Santiago 8380453, Chile

[5 ]Department of Basic Clinical Oncovirology, School of Medicine, Universidad de Chile, Santiago 7591047, Chile

[6 ]Department of Otolaryngology, Clínica Las Condes, Región Metropolitana 7500922, Chile

[7 ]Department of Otolaryngology, Hospital del Salvador, Región Metropolitana 8380453, Chile

[8 ]Department of Anatomic Pathology, National Cancer Institute, Santiago 8380000, Chile

[9 ]Department of Head and Neck Surgery, National Cancer Institute, Santiago 8380000, Chile

[10 ]Centro de Investigación y Especialidades Médicas (CDIEM), Santiago 7500859, Chile

[11 ]Department of Radiotherapy, Hospital Regional de Talca, Talca 3460001, Chile

[12 ]Department of Head and Neck Surgery, Clínica Alemana, Región Metropolitana 7650568, Chile

[13 ]School of Dentistry, Universidad de Chile, Santiago 8380453, Chile

[14 ]School of Medicine, Universidad de Chile, Santiago 8380453, Chile

[15 ]Management Information Area, Medical Subdirectorate of Institutional Development, National Cancer Institute, Santiago 8380000, Chile

[16 ]School of Medical Technology, School of Medicine, Universidad de Chile, Santiago 8380453, Chile

[17 ]Department of Medical Technology, School of Medicine, Universidad de Chile, Santiago 8380453, Chile

Author notes

Correspondence to: Felipe Carvajal V felipecarvajal@ 123456uchile.cl

Article

Publisher ID: can-18-1685

DOI: 10.3332/ecancer.2024.1685

PMC ID: 10984838

PubMed ID: 38566759

SO-VID: 7a47d3d9-a496-43d6-aac8-ac1b844e97ce

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 05 January 2024