[1220] Validation of the Risk Model in a New Patient Cohort with HNSCC

M Brandwein-Gensler, B Wang, C Penner, R Smith, M Prystowsky, N Schlecht, A Negassa. University Alabama, Birmingham, Al; NYU, NY, NY; University Manitoba, Winnipeg, MB, Canada; Montefiore/Einstein, Bronx, NY; Einstein, Bronx, NY

Background: Some patients with low-stage (LS) HNSCC are expected to fail single modality therapy, indicating that more aggressive treatment would have been warranted. Identifying LS patients at risk for disease progression (DP), for multimodality treatment, would represent an important advance. Our Risk Model may aid in developing new treatment paradigms. Here we report the performance of our model in a new multi-center cohort.
Design: Eligible patients were identified and resection slides were reviewed (MBG). Kaplan-Meier (KM) analysis was performed for DP and OS, stratified by risk category. Stratified Cox proportional hazard regression was performed, adjusted for potential confounders.
Results: Table 1 summarizes the cohort.

Table 1: Cohort data

	MMC	NYU	Manitoba
Number SCCs	225	30	56
Oral (%)	48	93	93
Oropharynx (%)	24	0	7
Larynx(%)	28	7	0
Age ீ60 (%)	37	47	45
Low stage (%)	37	50	46
High stage (%)	63	50	54

311 primary SCC developed in 306 patients

Risk predicts time to DP (p < 0.0001) (Fig 1) and OS (p < 0.0001) by KM.

Results of the Cox multivariate regression analysis is shown in Table 2. Patients with high-risk SCC are more likely to progress early, compared to the remaining patients, after adjusting for confounders (HR 2.20 95% CI 1.14, 4.25).

Table 2: Risk & Disease Progression - Cox Model

	HR	95% CI	p
High-risk	2.20	(1.14, 4.25)	0.019
Female	0.80	(0.46, 1.41)	0.442
Age ு 60	1.31	(0.77, 2.26)	0.323
Margin ∠ 5 mm	1.43	(0.78, 2.62)	0.242
Oropharynx	0.71	(0.31, 1.64)	0.425
Larynx	0.76	(0.35, 1.66)	0.490
T = 3/4	1.64	(0.89, 3.02)	0.112
LN+	1.01	(0.55, 1.87)	0.963
No adjuvant RT	1.37	(0.74, 2.54)	0.322

Larynx and oropharynx compared to oral cavity


Conclusions: We demonstrate the performance of the Risk Model in a new patient cohort, providing further evidence for using risk score to predict outcome in HNSCC patients.
Category: Head & Neck

Tuesday, March 23, 2010 1:00 PM

Poster Session IV # 152, Tuesday Afternoon