Prognostic value of radiographically defined extranodal extension in human papillomavirus‐associated locally advanced oropharyngeal carcinoma

• Published in: Head & neck Vol. 41; no. 9; pp. 3056 - 3063
• Main Authors: Tian, Sibo, Ferris, Matthew J., Switchenko, Jeffrey M., Magliocca, Kelly R., Cassidy, Richard J., Jhaveri, Jaymin, Aiken, Ashley H., Baugnon, Kristen L., Hudgins, Patricia A., Kendi, Ayse T. K., Patel, Mihir R., Saba, Nabil F., Curran, Walter J., Beitler, Jonathan J.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.09.2019; Wiley Subscription Services, Inc
• Subjects: Chemoradiotherapy; ENE; extranodal extension; Head & neck cancer; Head and neck; Health risk assessment; HPV; Human papillomavirus; Metastases; oropharynx cancer; p16; Squamous cell carcinoma; Throat cancer; oropharynx cancer; p16; ENE; HPV; extranodal extension
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.25791

Background Pathologic extranodal extension (ENE) has traditionally guided the management of head and neck cancers. The prognostic value of radiographic ENE (rENE) in human papillomavirus (HPV)‐associated oropharyngeal squamous cell carcinoma (HPV + OPX) is uncertain. Methods Patients with HPV + OPX with adequate pretreatment radiographic nodal evaluation from a single institution were analyzed. rENE status was determined by neuroradiologists' at time of diagnosis. Distant metastasis‐free survival (DMFS), overall survival (OS), and locoregional recurrence‐free survival (LRFS) were estimated using Kaplan‐Meier methods. Cox proportional hazards models were fit to assess the impact of rENE on survival endpoints. Results Hundred sixty‐eight patients with OPX + squamous cell carcinomas diagnosed between April 2008 and December 2014 were included for analysis with median follow‐up of 3.3 years. Eighty‐eight percent of patients received concurrent chemoradiotherapy. rENE was not prognostic; its presence in patients with HPV + OPX did not significantly impact OS, LRFS, or DMFS. Conclusions In patients with HPV + OPX, rENE was not significantly associated with OS, LRFS, or DMFS.