A prognosis is a prediction of the outcome of one’s disease. How likely is survival? Will the cancer come back? These are the big questions on most people’s minds after receiving a diagnosis of oropharyngeal cancer. In general, there are several characteristics of the tumor that can inform a patient about their chances of being cured.
Factors That Affect Prognosis
Stage
This is the most important factor that affects a patient’s chance of being cured and their overall survival.
Human Papillomavirus (HPV) Status
Unlike other head and neck cancers, squamous cell cancers of the oropharynx can be divided into HPV-mediated and non-HPV-mediated cancers. In general, patients with HPV-mediated oropharyngeal cancer have a better chance at being cured and better overall prognosis than those with non-HPV-mediated oropharyngeal cancer. This has been found to be a significant enough factor in oropharyngeal cancer that it was added to the staging system as one of the main determinants of cancer stage.
Spread to Lymph Nodes/Spread of Cancer Cells Outside Lymph Node Capsule
This helps determine stage, but even without other factors, spread to lymph nodes in the neck decreases the chance of cure, especially if there is evidence of growth of cancer outside of the lymph nodes. For HPV-mediated oropharyngeal cancer, the significance of extranodal extension (ENE) is still under investigation
Tumor Margins
The ability to completely remove the tumor with a margin of normal tissue around it can be a very important factor in a patient’s prognosis.
Spread into Local Structures
Spread into large nerves, skin, and bone has been shown to indicate a worse prognosis.
While each of these factors contributes to one’s outcome, patients should have a discussion with their doctor to determine their overall prognosis. Giving a percentage of survival is challenging because cancer research often looks at multiple types of cancer and may include a large range of patients who underwent a variety of treatments.
Survival Rates for Patients with Oropharyngeal Cancer
Stage I
Estimated Overall Survival at Five Years, HPV-positive Oropharyngeal Cancer
88%
Estimated Overall Survival at Five Years, HPV-negative Oropharyngeal Cancer
76%
Stage II
Estimated Overall Survival at Five Years, HPV-positive Oropharyngeal Cancer
82%
Estimated Overall Survival at Five Years, HPV-negative Oropharyngeal Cancer
68%
Stage III
Estimated Overall Survival at Five Years, HPV-positive Oropharyngeal Cancer
84%
Estimated Overall Survival at Five Years, HPV-negative Oropharyngeal Cancer
53%
Stage IVa
Estimated Overall Survival at Five Years, HPV-positive Oropharyngeal Cancer
81%
Estimated Overall Survival at Five Years, HPV-negative Oropharyngeal Cancer
45%
Stage IVb
Estimated Overall Survival at Five Years, HPV-positive Oropharyngeal Cancer
60%
Estimated Overall Survival at Five Years, HPV-negative Oropharyngeal Cancer
34%
Disclaimer: Estimated Disease-Specific Survival is the percentage of people with a specific cancer who are alive at a given time point, such as five years after diagnosis. It excludes people who may have died from a disease other than their cancer. While these estimates from large national databases are helpful, it is important to remember that these broad statistics may not apply to one’s individual situation.
