Retropharyngeal lymph node involvement in human papillomavirus–associated oropharyngeal squamous cell carcinoma. (30th July 2015)

• Record Type: Journal Article
• Authors: Baxter, Michael; Chan, Jason Y. K.; Mydlarz, Wojciech K.; Labruzzo, Salvatore V.; Kiess, Ana; Ha, Patrick K.; Nafi, Aygun; Nishant, Agrawal
• Is Part Of: Laryngoscope. Volume 125:Number 11(2015:Nov.)
• Page Start: 2503
• Page End: 2508
• Publication Date: 2015-07-30
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.25495
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="lary25495-sec-0001" sec-type="section"> <title>Objectives/Hypothesis</title> <p>The purpose of this study was to retrospectively review patients with human papillomavirus (HPV)–associated oropharyngeal squamous cell carcinoma (OPSCC) for the presence of retropharyngeal lymph nodes (RPLNs) prior to treatment using positron emission tomography/computed tomography (PET/CT), and to determine if the presence of RPLNs is of utility in predicting outcomes.</p> </sec> <sec id="lary25495-sec-0002" sec-type="section"> <title>Study Design</title> <p>Retrospective review of patient data from a single institution.</p> </sec> <sec id="lary25495-sec-0003" sec-type="section"> <title>Methods</title> <p>Two hundred thirty patients with a diagnosis of HPV‐associated OPSCC were identified from 2002 to 2013. The presence of RPLNs was determined primarily from findings on PET/CT as reviewed in a standardized fashion by two neuroradiologists.</p> </sec> <sec id="lary25495-sec-0004" sec-type="section"> <title>Results</title> <p>Of the 230 patients, 165 had pretreatment PET/CT imaging available for review. There were a total of 16 patients (9.70%) with evidence of RPLNs. Among patients positive for RPLNs pretreatment, with an average follow‐up of 2 years, there was a 5.2‐times greater odds of having recurrence or death (31.3% vs. 8.1%, <italic>P</italic> = .004). When T and N stage were adjusted for with multiple regression, there was no significant association between RPLN status and recurrence free survival.</p> </sec> <sec id="lary25495-sec-0005" sec-type="section"> <title>Conclusions</title> <p>This is a unique investigation utilizing PET/CT to classify RPLN status in HPV‐associated OPSCC. RPLNs were relatively common in our HPV‐associated OPSCC cohort at 9.70%, at the low end of the quoted positivity of 10% to 27% in all OPSCC. A combination of PET/CT is useful in identifying RPLNs. Prospective investigation will be needed to determine the sensitivity and specificity of PET/CT in identifying RPLNs, and the precise impact of RPLNs on HPV‐associated OPSCC treatment and outcomes.</p> </sec> <sec id="lary25495-sec-0006" sec-type="section"> <title>Level of Evidence</title> <p>4. <italic>Laryngoscope</italic>, 125:2503–2508, 2015</p> </sec> </abstract>