Abstract
Objective: 1) To evaluate p16 status as a predictor of quality of life (QOL) in oral and oropharyngeal squamous cell carcinoma (OSCC). 2) To identify independent predictive factors of QOL in OSCC.
Methods: 1) We conducted a cross-sectional study on 156 OSCC patients. Patients were evaluated using 3 validated QOL questionnaires (EORTC QLQ-C30, EORTC QLQ-HN35, HADS). HPV status was determined using p16 status on immunohistochemistry staining on paraffin blocks. Using chi-square and t test analyses, we identified the value of p16 as a predictor of QOL. 2) Patient factors, tumor factors, risk factors, and treatment factors were then identified on medical record review. Bivariate analyses identified predictors of QOL, and multivariate regression analyses identified factors with independent significance.
Results: QOL data were collected for 156 patients. Mean and median follow-up times were 63.2 and 35.0 months. Pretreatment tumor p16 status was available for 88 patients. Pretreatment p16 status did not significantly predict QOL as evaluated by our questionnaires. However, anemia at diagnosis independently predicted long-term global QOL. T classification predicted long-term depression, pain, function, and social contact. Number of medications was used as a surrogate of comorbidities, and predicted long-term pain and depression. Mandibulectomy predicted long-term pain.
Conclusion: This is the first study in the literature to evaluate the impact of p16 status on prediction of QOL in OSCC. Pretreatment anemia is an independent predictive factor of QOL. Number of medications is used as a surrogate of comorbidities in this study and is an independent and significant predictor of long-term QOL in OSCC.
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