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A model using conco...
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Bersani, CinziaKarolinska Institutet
(author)
A model using concomitant markers for predicting outcome in human papillomavirus positive oropharyngeal cancer
- Article/chapterEnglish2017
Publisher, publication year, extent ...
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Elsevier,2017
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:umu-137406
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-137406URI
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https://doi.org/10.1016/j.oraloncology.2017.03.007DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:136004892URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Objective: Head-neck cancer therapy has become intensified. With radiotherapy alone, 3-year disease-free survival (DFS) is 80% for HPV-positive TSCC/BOTSCC and better for patients with favorable characteristics, suggesting therapy could be tapered for some, decreasing side-effects. Therefore, we built a model to predict progression-free survival for patients with HPV-positive TSCC and BOTSCC. Material and methods: TSCC/BOTSCC patients treated curatively between 2000 and 2011, with HPV16 DNA/E7 mRNA positive tumors examined for CD8(+) TILs, HPV16 mRNA and HLA class I expression were included. Patients were split randomly 65/35 into training and validation sets, and LASSO regression was used to select a model in the training set, the performance of which was evaluated in the validation set. Results: 258 patients with HPV DNA/E7 mRNA positive tumors could be included, 168 and 90 patients in the respective sets. No treatment improved prognosis compared to radiotherapy alone. CD8(+) TIL counts and young age were the strongest predictors of survival, followed by T-stage <3 and presence of HPV16 E2 mRNA. The model had an area under curve (AUC) of 76%. A model where the presence of three of four of these markers defined good prognosis captured 56% of non-relapsing patients with a positive predictive value of 98% in the validation set. Furthermore, the model identified 35% of our cohort that was over-treated and could safely have received de-escalated therapy. Conclusion: CD8(+) TIL counts, age, T-stage and E2 expression could predict progression-free survival, identifying patients eligible for randomized trials with milder treatment, potentially reducing side effects without worsening prognosis.
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Mints, MichaelKarolinska Institutet,Umeå universitet,Institutionen för kirurgisk och perioperativ vetenskap,Dept. of Medicine, Karolinska Institutet, Stockholm, Sweden(Swepub:umu)mimi0028
(author)
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Tertipis, Nikolaos
(author)
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Haeggblom, LinneaKarolinska Institutet
(author)
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Sivars, LarsKarolinska Institutet
(author)
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Ährlund-Richter, Andreas
(author)
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Vlastos, Andrea
(author)
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Smedberg, Cecilia
(author)
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Grün, Nathalie
(author)
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Munck-Wikland, EvaKarolinska Institutet
(author)
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Näsman, AndersKarolinska Institutet
(author)
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Ramqvist, TorbjörnKarolinska Institutet
(author)
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Dalianis, TinaKarolinska Institutet
(author)
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Karolinska InstitutetInstitutionen för kirurgisk och perioperativ vetenskap
(creator_code:org_t)
Related titles
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In:Oral Oncology: Elsevier68, s. 53-591368-83751879-0593
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Bersani, Cinzia
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Mints, Michael
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Tertipis, Nikola ...
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Haeggblom, Linne ...
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Sivars, Lars
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Ährlund-Richter, ...
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Vlastos, Andrea
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Smedberg, Cecili ...
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Grün, Nathalie
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Munck-Wikland, E ...
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Näsman, Anders
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Ramqvist, Torbjö ...
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Dalianis, Tina
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Dentistry
- Articles in the publication
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Oral Oncology
- By the university
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Umeå University
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Karolinska Institutet