[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
Number SCCs2253056
Oral (%)489393
Oropharynx (%)2407
Age ீ60 (%)374745
Low stage (%)375046
High stage (%)635054
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
HR95% CIp
High-risk2.20(1.14, 4.25)0.019
Female0.80(0.46, 1.41)0.442
Age ு 601.31(0.77, 2.26)0.323
Margin ∠ 5 mm1.43(0.78, 2.62)0.242
Oropharynx0.71(0.31, 1.64)0.425
Larynx0.76(0.35, 1.66)0.490
T = 3/41.64(0.89, 3.02)0.112
LN+1.01(0.55, 1.87)0.963
No adjuvant RT1.37(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


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