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Patterns and distribution of regional nodal involvement and recurrence in a surgically treated oropharyngeal squamous cell carcinoma cohort at a tertiary center.
Abdel-Halim, Chadi N; O'Byrne, Thomas J; Graves, Jeffrey P; Akpala, Christeebella O; Moore, Eric J; Price, Daniel L; Tasche, Kendall T; Ma, Daniel J; Neben-Wittich, Michelle A; Lester, Scott C; Gamez, Mauricio; Price, Katharine A; Bayne, Harry E Fuentes; Rwigema, Jean Claude M; Patel, Samir H; McGee, Lisa A; Janus, Jeffrey R; Nagel, Thomas H; Hinni, Michael L; Savvides, Panayiotis S; Van Abel, Kathryn M; Routman, David M.
Afiliación
  • Abdel-Halim CN; Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States.
  • O'Byrne TJ; Department of Quantitative Health Sciences, Rochester, MN, United States.
  • Graves JP; Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States.
  • Akpala CO; Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States.
  • Moore EJ; Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States.
  • Price DL; Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States.
  • Tasche KT; Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States.
  • Ma DJ; Department of Radiation Oncology, Mayo Clinic, Rochester, MN, United States.
  • Neben-Wittich MA; Department of Radiation Oncology, Mayo Clinic, Rochester, MN, United States.
  • Lester SC; Department of Radiation Oncology, Mayo Clinic, Rochester, MN, United States.
  • Gamez M; Department of Radiation Oncology, Mayo Clinic, Rochester, MN, United States.
  • Price KA; Department of Medical Oncology, Mayo Clinic, Rochester, MN, United States.
  • Bayne HEF; Department of Medical Oncology, Mayo Clinic, Rochester, MN, United States.
  • Rwigema JCM; Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, United States.
  • Patel SH; Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, United States.
  • McGee LA; Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, United States.
  • Janus JR; Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Jacksonville, FL, United States.
  • Nagel TH; Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Scottsdale, AZ, United States.
  • Hinni ML; Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Scottsdale, AZ, United States.
  • Savvides PS; Department of Medical Oncology, Mayo Clinic, Phoenix, AZ, United States.
  • Van Abel KM; Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States. Electronic address: vanabel.kathryn@mayo.edu.
  • Routman DM; Department of Radiation Oncology, Mayo Clinic, Rochester, MN, United States.
Oral Oncol ; 146: 106569, 2023 11.
Article en En | MEDLINE | ID: mdl-37734203
OBJECTIVES: To investigate and describe the patterns of regional metastases and recurrences after surgical treatment of oropharyngeal squamous cell cancer (OPSCC). MATERIALS AND METHODS: Retrospective study of patients diagnosed with OPSCC from 2006 to 2021 at a tertiary referral center. Only patients treated with surgery including a neck dissection were included. Patients with unknown human papillomavirus (HPV) status, prior head and neck cancer, distant metastases, or synchronous head and neck cancer were excluded. RESULTS: A total of 928 patients were included. 89% were males, the average age was 58.6 years (range: 25.2-87.5), 874 (94%) were HPV(+), and 513 (55.3%) had a tonsil cancer. Among cN + patients, the most commonly involved levels at presentation were level II (85.2%), level III (33.3%), and level IV (9.4%). In cN0 patients, metastases were only observed in level II (16.2%) and level III (9.2%). Nodal recurrence occurred in 48 (5.2%) patients after a median time of 1.0 years (interquartile range: 0.6-2.0). Nodal recurrence incidence was similar in HPV(+) and HPV(-) patients (5.0% vs. 7.4%, p = 0.44). The most common levels for regional recurrence were ipsilateral level II (45.8%), contralateral level II (43.8%), and ipsilateral level V (25.0%). Multivariable analysis revealed that pN was a significant predictor for regional recurrence (p = 0.02). CONCLUSION: There is no difference in the distribution of regional metastases and recurrences in HPV(+) and HPV(-) OPSCC patients. Our findings align with the established understanding that regional metastases predominantly manifest in the ipsilateral level II-IV at presentation. Moreover, the data support the clinical recommendation to restrict elective neck dissection in cN0 patients to ipsilateral levels IIa and III, excluding level IIb. Regional recurrence is significantly associated with pN status.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Células Escamosas / Neoplasias Orofaríngeas / Infecciones por Papillomavirus / Neoplasias de Cabeza y Cuello Tipo de estudio: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Oral Oncol Asunto de la revista: NEOPLASIAS Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Células Escamosas / Neoplasias Orofaríngeas / Infecciones por Papillomavirus / Neoplasias de Cabeza y Cuello Tipo de estudio: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Oral Oncol Asunto de la revista: NEOPLASIAS Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido