Abstract B26: Analysis and comparison of survival and functional outcomes in oropharyngeal squamous cell carcinoma patients within City of Hope Cancer Center sites
Authors: Pharaon Rebecca R. , Maghami Ellie , Amini Arya , Mohanty Atish , Vora Nayana , Chang Sue , Gernon Thomas , Kang Robert , Vora Lalit , Chung Samuel , Sampath Sagus , Massarelli Erminia 
Published: September 2020

Introduction: Oropharyngeal squamous cell (OPSCC) is a subset of head and neck cancers and is known to be associated with human papillomavirus (HPV). We designed a retrospective analysis to determine differences in survival and functional outcomes of OPSCC patients treated at City of Hope (COH) Cancer Center’s main campus versus selected satellite sites with COH-associated faculty and facilities.

Methods and Materials: A retrospective analysis was done on patients diagnosed with OPSCC and treated with concurrent chemoradiation therapy from May 2009 to February 2017 at COH main campus or satellite sites. Eligible patients (N=94) had available demographic data, treatment data, survival and functional outcomes, and recent follow-up at a COH site.

Results: 50 patients underwent treatment at the COH main campus and 44 at its satellite sites. Majority of patients were Caucasian (38 patients at main campus, 32 patients at satellite sites), male (40 at main campus, 39 at satellite sites), diagnosed with stage IV locally advanced OPSCC by AJCC 7th edition (43 vs. 32 patients), and p16 positive (42 vs. 30 patients). There was an equal smoking history distribution within our cohort (50% never smokers, 50% former/current smokers at both sites). A small subset of patients at both sites underwent surgical resection prior to concurrent chemoradiation (N=23, 25%). Chemotherapy agents chosen for treatment included cisplatin, carboplatin, cetuximab, and platinum/paclitaxel. Cisplatin was highly favored at the main campus (N=39, 78%); cisplatin (N=21, 48%) and cetuximab (N=21, 48%) use was equally distributed at the satellite sites. Of the 60 cisplatin-treated patients, 58 (98%) received the recommended total minimum dose of 200 mg/m2. Majority of patients completed their prescribed cumulative radiation therapy dose (50-70 Gray) (49 [98%] at main campus, 43 [98%] at satellite sites) and had a complete response to treatment (35 [70%] at main campus, 37 [84%] at satellite sites). There were few hospitalizations during the course of treatment (6 at the main campus, 4 at the satellite sites). 12 patients (24%) at the main campus and 19 patients (43%) at the satellite sites underwent feeding tube placement. A trend toward significant difference in feeding tube dependency at 6 months was observed between the main campus (N=2) and satellite sites (N=11) (17% vs. 58%, p=0.08). No significant difference in the 2-year recurrence rate was observed between the main campus (N=5) and the satellite sites (N=7) (10% vs. 16%, p&gt;0.05).

Conclusion: Our retrospective analysis highlights comparable recurrence rates between a major tertiary cancer center and selected satellite sites with dedicated radiation and medical oncology faculty and facilities. Discrepancies in the feeding tube dependency rates could be potentially overcome by integration of supportive services between satellites and main campus. This study also highlights the importance of telehealth services in major institutions.

Citation Format: Rebecca R. Pharaon, Ellie Maghami, Arya Amini, Atish Mohanty, Nayana Vora, Sue Chang, Thomas Gernon, Robert Kang, Lalit Vora, Samuel Chung, Sagus Sampath, Erminia Massarelli. Analysis and comparison of survival and functional outcomes in oropharyngeal squamous cell carcinoma patients within City of Hope Cancer Center sites [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Optimizing Survival and Quality of Life through Basic, Clinical, and Translational Research; 2019 Apr 29-30; Austin, TX. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(12_Suppl_2):Abstract nr B26.