Radiographic nodal prognostic factors in stage I HPV‐related oropharyngeal squamous cell carcinoma. Issue 2 (15th December 2018)

• Record Type: Journal Article
• Authors: Bhattasali, Onita; Thompson, Lester D. R.; Schumacher, Andrew J.; Iganej, Shawn
• Is Part Of: Head & neck. Volume 41:Issue 2(2019)
• Page Start: 398
• Page End: 402
• Publication Date: 2018-12-15
• Subjects: HPV‐associated -- low‐neck lymphadenopathy -- oropharyngeal cancer -- p16‐positive -- retropharyngeal lymphadenopathy; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.25504
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: The updated AJCC Cancer Staging Manual groups all p16‐positive oropharyngeal squamous cell carcinoma (OPSCC) with unilateral nodal involvement within 6 cm into the new clinical N1 classification, consolidating a heterogeneous group of disease with varying radiographic findings. Methods: A central radiological review was conducted identifying 233 patients with stage I node‐positive (cT1‐2N1) disease who underwent definitive concurrent chemoradiation. Factors evaluated included lymph node size, low‐neck lymphadenopathy, retropharyngeal lymphadenopathy, overt radiographic extracapsular extension, and matted lymphadenopathy. Results: On multivariate analysis adjusted for age, smoking history, and chemotherapy regimen, low‐neck lymphadenopathy (hazard ratio (HR) = 6.55; P < .001) and retropharyngeal lymphadenopathy (HR = 3.36; P = .009) predicted for inferior progression‐free survival (PFS). low‐neck lymphadenopathy (HR = 6.38; P = .001) and retropharyngeal lymphadenopathy (HR = 3.32; P = .02) also predicted for inferior overall survival (OS). All other radiographic characteristics showed no prognostic impact for PFS or OS. Conclusions: This analysis suggests that caution should be advised against de‐intensification efforts among patients with stage I node‐positive p16‐positive OPSCC with low‐neck lymphadenopathy or retropharyngeal lymphadenopathy.