The influence of tumor volume on the risk of distant metastases in head and neck squamous cell carcinomas

Julie Kjems; Katrin Elisabet Håkansson; Claus Andrup Kristensen; Jesper Grau Eriksen; Morten Horsholt Kristensen; Anne Ivalu Sander Holm; Jens Overgaard; Christian Rønn Hansen; Ruta Zukauskaite; Jørgen Johansen; Ivan Richter Vogelius; Jeppe Friborg

doi:10.1016/j.radonc.2023.109771

The influence of tumor volume on the risk of distant metastases in head and neck squamous cell carcinomas

Julie Kjems^*, Katrin Elisabet Håkansson, Claus Andrup Kristensen, Jesper Grau Eriksen, Morten Horsholt Kristensen, Anne Ivalu Sander Holm, Jens Overgaard, Christian Rønn Hansen, Ruta Zukauskaite, Jørgen Johansen, Ivan Richter Vogelius, Jeppe Friborg

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

Abstract

Background and purpose: Distant metastases (DM) in head and neck squamous cell carcinomas (HNSCC) are in most circumstances non-curable. The TNM staging system is insufficient to predict the risk of DM. This study investigates if the DM risk can be predicted using a multivariate model including pre-treatment total tumor volume for both p16-positive oropharyngeal squamous cell carcinoma (OPSCC) and all other sites (other HNSCC). Materials and methods: The study includes patients with localized pharyngeal and laryngeal squamous cell carcinomas treated with primary radiotherapy from 2008-2017 from three head and neck cancer centers. Patients were identified in the Danish Head and Neck Cancer (DAHANCA) database. Total (nodal and primary) tumor volume (Gross Tumor Volume, GTV) was extracted from local treatment planning systems. The GTV was grouped by volume (cm³) in four intervals and included in a multivariate Cox proportional hazard regression controlled for pre-selected clinical values incl. stage. Results: The study includes 2,865 patients, of which 321 (11 %) had DM post-treatment. The risk of DM was assessed in a multivariate model based on 2,751 patients (p16-positive OPSCC: 1,032; and other HNSCC: 1,719). There was a significant association between GTV and the risk of DM, and in tumor volumes ≥ 50 cm³ hazard ratios of 7.6 (2.5–23.4) for p16-positive OPSCC and 4.1 (2.3–7.2) in other HNSCC were observed. Conclusion: Tumor volume is an independent risk factor for DM. The addition of total tumor volume to a predictive model is important to identify subgroups of HNSCC patients at high risk of DM.

Originalsprog	Engelsk
Artikelnummer	109771
Tidsskrift	Radiotherapy and Oncology
Vol/bind	186
ISSN	0167-8140
DOI	https://doi.org/10.1016/j.radonc.2023.109771
Status	Udgivet - sep. 2023

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10.1016/j.radonc.2023.109771Licens: CC BY

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Kjems, J., Elisabet Håkansson, K., Andrup Kristensen, C., Grau Eriksen, J., Horsholt Kristensen, M., Ivalu Sander Holm, A., Overgaard, J., Rønn Hansen, C., Zukauskaite, R., Johansen, J., Richter Vogelius, I., & Friborg, J. (2023). The influence of tumor volume on the risk of distant metastases in head and neck squamous cell carcinomas. Radiotherapy and Oncology, 186, Artikel 109771. https://doi.org/10.1016/j.radonc.2023.109771

@article{0efb12b00de4489687c7c3fd891894f0,

title = "The influence of tumor volume on the risk of distant metastases in head and neck squamous cell carcinomas",

abstract = "Background and purpose: Distant metastases (DM) in head and neck squamous cell carcinomas (HNSCC) are in most circumstances non-curable. The TNM staging system is insufficient to predict the risk of DM. This study investigates if the DM risk can be predicted using a multivariate model including pre-treatment total tumor volume for both p16-positive oropharyngeal squamous cell carcinoma (OPSCC) and all other sites (other HNSCC). Materials and methods: The study includes patients with localized pharyngeal and laryngeal squamous cell carcinomas treated with primary radiotherapy from 2008-2017 from three head and neck cancer centers. Patients were identified in the Danish Head and Neck Cancer (DAHANCA) database. Total (nodal and primary) tumor volume (Gross Tumor Volume, GTV) was extracted from local treatment planning systems. The GTV was grouped by volume (cm3) in four intervals and included in a multivariate Cox proportional hazard regression controlled for pre-selected clinical values incl. stage. Results: The study includes 2,865 patients, of which 321 (11 %) had DM post-treatment. The risk of DM was assessed in a multivariate model based on 2,751 patients (p16-positive OPSCC: 1,032; and other HNSCC: 1,719). There was a significant association between GTV and the risk of DM, and in tumor volumes ≥ 50 cm3 hazard ratios of 7.6 (2.5–23.4) for p16-positive OPSCC and 4.1 (2.3–7.2) in other HNSCC were observed. Conclusion: Tumor volume is an independent risk factor for DM. The addition of total tumor volume to a predictive model is important to identify subgroups of HNSCC patients at high risk of DM.",

keywords = "Head and neck cancer, Laryngeal cancer, Metastasis, Pharyngeal cancer, Radiotherapy, Tumor volume",

author = "Julie Kjems and {Elisabet H{\aa}kansson}, Katrin and {Andrup Kristensen}, Claus and {Grau Eriksen}, Jesper and {Horsholt Kristensen}, Morten and {Ivalu Sander Holm}, Anne and Jens Overgaard and {R{\o}nn Hansen}, Christian and Ruta Zukauskaite and J{\o}rgen Johansen and {Richter Vogelius}, Ivan and Jeppe Friborg",

note = "Publisher Copyright: {\textcopyright} 2023 The Author(s)",

year = "2023",

month = sep,

doi = "10.1016/j.radonc.2023.109771",

language = "English",

volume = "186",

journal = "Radiotherapy and Oncology",

issn = "0167-8140",

publisher = "Elsevier Ireland Ltd.",

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Kjems, J, Elisabet Håkansson, K, Andrup Kristensen, C, Grau Eriksen, J , Horsholt Kristensen, M, Ivalu Sander Holm, A, Overgaard, J, Rønn Hansen, C, Zukauskaite, R, Johansen, J, Richter Vogelius, I & Friborg, J 2023, 'The influence of tumor volume on the risk of distant metastases in head and neck squamous cell carcinomas', Radiotherapy and Oncology, bind 186, 109771. https://doi.org/10.1016/j.radonc.2023.109771

The influence of tumor volume on the risk of distant metastases in head and neck squamous cell carcinomas. / Kjems, Julie; Elisabet Håkansson, Katrin; Andrup Kristensen, Claus et al.
I: Radiotherapy and Oncology, Bind 186, 109771, 09.2023.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - The influence of tumor volume on the risk of distant metastases in head and neck squamous cell carcinomas

AU - Kjems, Julie

AU - Elisabet Håkansson, Katrin

AU - Andrup Kristensen, Claus

AU - Grau Eriksen, Jesper

AU - Horsholt Kristensen, Morten

AU - Ivalu Sander Holm, Anne

AU - Overgaard, Jens

AU - Rønn Hansen, Christian

AU - Zukauskaite, Ruta

AU - Johansen, Jørgen

AU - Richter Vogelius, Ivan

AU - Friborg, Jeppe

PY - 2023/9

Y1 - 2023/9

N2 - Background and purpose: Distant metastases (DM) in head and neck squamous cell carcinomas (HNSCC) are in most circumstances non-curable. The TNM staging system is insufficient to predict the risk of DM. This study investigates if the DM risk can be predicted using a multivariate model including pre-treatment total tumor volume for both p16-positive oropharyngeal squamous cell carcinoma (OPSCC) and all other sites (other HNSCC). Materials and methods: The study includes patients with localized pharyngeal and laryngeal squamous cell carcinomas treated with primary radiotherapy from 2008-2017 from three head and neck cancer centers. Patients were identified in the Danish Head and Neck Cancer (DAHANCA) database. Total (nodal and primary) tumor volume (Gross Tumor Volume, GTV) was extracted from local treatment planning systems. The GTV was grouped by volume (cm3) in four intervals and included in a multivariate Cox proportional hazard regression controlled for pre-selected clinical values incl. stage. Results: The study includes 2,865 patients, of which 321 (11 %) had DM post-treatment. The risk of DM was assessed in a multivariate model based on 2,751 patients (p16-positive OPSCC: 1,032; and other HNSCC: 1,719). There was a significant association between GTV and the risk of DM, and in tumor volumes ≥ 50 cm3 hazard ratios of 7.6 (2.5–23.4) for p16-positive OPSCC and 4.1 (2.3–7.2) in other HNSCC were observed. Conclusion: Tumor volume is an independent risk factor for DM. The addition of total tumor volume to a predictive model is important to identify subgroups of HNSCC patients at high risk of DM.

AB - Background and purpose: Distant metastases (DM) in head and neck squamous cell carcinomas (HNSCC) are in most circumstances non-curable. The TNM staging system is insufficient to predict the risk of DM. This study investigates if the DM risk can be predicted using a multivariate model including pre-treatment total tumor volume for both p16-positive oropharyngeal squamous cell carcinoma (OPSCC) and all other sites (other HNSCC). Materials and methods: The study includes patients with localized pharyngeal and laryngeal squamous cell carcinomas treated with primary radiotherapy from 2008-2017 from three head and neck cancer centers. Patients were identified in the Danish Head and Neck Cancer (DAHANCA) database. Total (nodal and primary) tumor volume (Gross Tumor Volume, GTV) was extracted from local treatment planning systems. The GTV was grouped by volume (cm3) in four intervals and included in a multivariate Cox proportional hazard regression controlled for pre-selected clinical values incl. stage. Results: The study includes 2,865 patients, of which 321 (11 %) had DM post-treatment. The risk of DM was assessed in a multivariate model based on 2,751 patients (p16-positive OPSCC: 1,032; and other HNSCC: 1,719). There was a significant association between GTV and the risk of DM, and in tumor volumes ≥ 50 cm3 hazard ratios of 7.6 (2.5–23.4) for p16-positive OPSCC and 4.1 (2.3–7.2) in other HNSCC were observed. Conclusion: Tumor volume is an independent risk factor for DM. The addition of total tumor volume to a predictive model is important to identify subgroups of HNSCC patients at high risk of DM.

KW - Head and neck cancer

KW - Laryngeal cancer

KW - Metastasis

KW - Pharyngeal cancer

KW - Radiotherapy

KW - Tumor volume

UR - http://www.scopus.com/inward/record.url?scp=85164305702&partnerID=8YFLogxK

U2 - 10.1016/j.radonc.2023.109771

DO - 10.1016/j.radonc.2023.109771

M3 - Journal article

C2 - 37385382

AN - SCOPUS:85164305702

SN - 0167-8140

VL - 186

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

M1 - 109771

ER -

The influence of tumor volume on the risk of distant metastases in head and neck squamous cell carcinomas

Abstract

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