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- Title
Patterns of nodal metastasis and prognosis in human papillomavirus-positive oropharyngeal squamous cell carcinoma.
- Authors
Spector, Matthew E.; Gallagher, K. Kelly; Bellile, Emily; Chinn, Steven B.; Ibrahim, Mohannad; Byrd, Serena; Chanowski, Eric J.; Walline, Heather M.; Moyer, Jeffrey S.; Prince, Mark E.; Wolf, Gregory T.; Bradford, Carol R.; McHugh, Jonathan B.; Cordell, Kitrina; Carey, Thomas; Worden, Francis P.; Eisbruch, Avraham; Chepeha, Douglas B.
- Abstract
Background The current American Joint Committee on Cancer (AJCC) staging system may not accurately reflect survival in patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (SCC). The purpose of this study was to develop a system that more precisely predicts survival. Methods CT scans from 156 patients who underwent chemoradiation for advanced-stage oropharyngeal SCC with >2 years follow-up were reviewed. We modeled patterns of nodal metastasis associated with different survival rates. We defined HPV+N1 as a single node <6 cm, ipsilaterally, contralaterally, or bilaterally. HPV+N2 was defined as a single node ≥6 cm or ≥2 nodes ipsilaterally/contralaterally or ≥3 nodes bilaterally. HPV+N3 was defined as matted nodes. Results There was no significant difference in disease-specific survival (DSS; p = .14) or overall survival (OS; p = .16) by AJCC classification. In patients grouped by HPV+N1, HPV+N2, and HPV+N3 nodal classification, significant differences in DSS (100%, 92%, and 55%, respectively; p = .0001) and OS (100%, 96%, and 55%, respectively; p = .0001) were found. Conclusion A staging system with reclassification of size, bilaterality, and matted nodes more accurately reflects survival differences in this cohort of patients. Review of the AJCC staging system with these criteria should be considered for HPV-positive oropharyngeal SCC. © 2014 Wiley Periodicals, Inc. Head Neck 36: 1233-1240, 2014
- Subjects
METASTASIS; SQUAMOUS cell carcinoma; PAPILLOMAVIRUSES; DISEASE progression; SURVIVAL analysis (Biometry); COMPUTED tomography; POSITRON emission tomography; DIAGNOSIS
- Publication
Head & Neck, 2014, Vol 36, Issue 9, p1233
- ISSN
1043-3074
- Publication type
Article
- DOI
10.1002/hed.23438