Systematic Review of Second Primary Oropharyngeal Cancers in Patients With p16+ Oropharyngeal Cancer. Otolaryngol Head Neck Surg 2021 Apr;164(4):733-740
Date
09/16/2020Pubmed ID
32928026DOI
10.1177/0194599820951175Scopus ID
2-s2.0-85091007007 (requires institutional sign-in at Scopus site) 4 CitationsAbstract
OBJECTIVE: To systematically review the literature to determine the prevalence and clinical outcomes of second primary oropharyngeal squamous cell carcinoma (OPSCC).
DATA SOURCES: Search strategies created with a medical librarian were implemented using multiple databases in October 2019.
REVIEW METHODS: The population of interest included adults age >18 years with a p16+ or human papillomavirus-positive OPSCC. The outcome was a synchronous or metachronous second primary OPSCC. Inclusion and exclusion criteria were designed to capture all study designs. In total, 685 records were identified by the search strategy. Two reviewers independently performed the review, extracted data, and performed a quality assessment. Primary Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A random-effects model was used for the meta-analysis.
RESULTS: A total of 2470 patients with 35 second primary OPSCCs from 15 studies were identified. The pooled prevalence of second primary OPSCC was 1.4% (range, 0%-14.3%). In the random-effects model, the prevalence was estimated at 1.3% (95% CI, 0.7%-2.3%; P = .51, I2 = 52%). Of the 30 patients with treatment information, 26 (86.7%) received surgical treatment, while 4 (13.3%) underwent nonsurgical therapy. Of the 29 patients with available survival information, 22 (75.9%) had no evidence of disease at last follow-up, 5 (17.2%) ultimately died of disease, and 2 (6.9%) were alive with disease.
CONCLUSION: Overall, the rate of second primary OPSCC in patients with an index p16+ OPSCC is low, and most patients are successfully treated. Insufficient evidence currently exists to recommend routine elective tonsillectomy during surgical treatment of p16+ OPSCC.
Author List
Bollig CA, Lee DS, Mazul AL, Stepan K, Puram SV, Massa ST, Zenga J, Faden DL, Doering MM, Jackson RS, Pipkorn PAuthor
Joseph Zenga MD Assistant Professor in the Otolaryngology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultCyclin-Dependent Kinase Inhibitor p16
Head and Neck Neoplasms
Humans
Neoplasms, Second Primary
Papillomavirus Infections
Prevalence
