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- Title
Prognostic value of lymph node ratio versus American Joint Committee on Cancer N classification for surgically resected human papillomavirus‐associated oropharyngeal squamous cell carcinoma.
- Authors
Nocon, Cheryl C.; Kuchta, Kristine; Bhayani, Mihir K.
- Abstract
Background: We compared prognostic values of lymph node ratio (LNR) and AJCC 8 N classification in surgically resected human papillomavirus (HPV)‐associated oropharyngeal squamous cell carcinoma (OPSCC). Methods: Using the National Cancer Database, we identified patients with HPV‐associated OPSCC from 2010 to 2016 who underwent definitive surgical resection. Patients were analyzed by nodal grouping (LNR, N stage) and adjuvant radiation therapy(RT). Primary endpoint was overall survival. Results: We identified 4166 patients. Survival analysis showed significant improvement for LNR≤6% versus >6% (5 year OS% 92.7% vs. 83.7%, p < 0.001). N classification demonstrated good prognostic ability (5 year OS% for pN0, pN1, pN2 were 91.3%, 90.1%, 78.8%, p < 0.001), but poor separation among stages (compared to pN0: pN1 HR 1.40 [95% CI 0.63, 3.09], p = 0.41; pN2 HR 2.50 [95% CI 1.08, 5.81], p = 0.033). RT improved survival in the LNR > 6% group (5 year OS% 85.4% vs. 74.9%, p < 0.001; HR 0.41 [95% CI 0.28, 0.58], p < 0.001). Conclusions: LNR should be considered an adjunct category in future staging systems for HPV‐associated OPSCC.
- Subjects
SQUAMOUS cell carcinoma; PROGNOSIS; LYMPH nodes; TUMOR classification
- Publication
Head & Neck, 2021, Vol 43, Issue 5, p1476
- ISSN
1043-3074
- Publication type
Article
- DOI
10.1002/hed.26605