Amit J Sood1, Wesley McIlwain1, Brendan O'Connell1, Shaun Nguyen1, Jeffrey J Houlton1, Terry Day2. 1. Department of Otolaryngology- Head and Neck Surgery, Medical University of South Carolina. 2. Department of Otolaryngology- Head and Neck Surgery, Medical University of South Carolina. Electronic address: headneck@musc.edu.
Abstract
PURPOSE: To evaluate the association between T-stage and primary tumor subsite with clinical nodal metastasis in HPV-positive oropharyngeal squamous cell carcinomas. STUDY DESIGN: Retrospective medical record review. MATERIALS AND METHODS: A retrospective analysis of all previously untreated patients with HPV-positive oropharyngeal squamous cell carcinoma evaluated by the senior author in a tertiary-care center over a 5-year period was performed. Medical records were evaluated for HPV status, clinical T-stage, clinical nodal stage, and anatomic location of primary oropharyngeal subsite. RESULTS: 83% (59/71) of patients presented with clinical nodal disease. T-stage was not associated with the absence of regional disease (cN0) in tonsillar complex or base of tongue cancers. However, early T1/T2 tonsillar complex cancers were less likely to present with cN2c disease compared to T3/T4 lesions (0% vs. 18-33%, p=0.03). Further, base of tongue cancers were more likely to present with cN2c disease compared to tonsillar complex tumors (35% vs. 7%, p=0.01). CONCLUSION: In HPV-positive tonsillar complex cancers, T-stage does not appear to predict the presence of clinical nodal metastasis (N0 vs. N1-N3), but may predict the extent of metastasis when present. This association does not appear to affect base of tongue cancers. Further, base of tongue cancers have a greater incidence of cN2c disease compared to tonsillar complex cancers.
PURPOSE: To evaluate the association between T-stage and primary tumor subsite with clinical nodal metastasis in HPV-positive oropharyngeal squamous cell carcinomas. STUDY DESIGN: Retrospective medical record review. MATERIALS AND METHODS: A retrospective analysis of all previously untreated patients with HPV-positive oropharyngeal squamous cell carcinoma evaluated by the senior author in a tertiary-care center over a 5-year period was performed. Medical records were evaluated for HPV status, clinical T-stage, clinical nodal stage, and anatomic location of primary oropharyngeal subsite. RESULTS: 83% (59/71) of patients presented with clinical nodal disease. T-stage was not associated with the absence of regional disease (cN0) in tonsillar complex or base of tongue cancers. However, early T1/T2 tonsillar complex cancers were less likely to present with cN2c disease compared to T3/T4 lesions (0% vs. 18-33%, p=0.03). Further, base of tongue cancers were more likely to present with cN2c disease compared to tonsillar complex tumors (35% vs. 7%, p=0.01). CONCLUSION: In HPV-positive tonsillar complex cancers, T-stage does not appear to predict the presence of clinical nodal metastasis (N0 vs. N1-N3), but may predict the extent of metastasis when present. This association does not appear to affect base of tongue cancers. Further, base of tongue cancers have a greater incidence of cN2c disease compared to tonsillar complex cancers.
Authors: Aisling S Last; Patrik Pipkorn; Stephanie Chen; Dorina Kallogjeri; Joseph Zenga; Jason T Rich; Randal Paniello; Jose Zevallos; Rebecca Chernock; Douglas Adkins; Peter Oppelt; Hiram Gay; Mackenzie Daly; Wade Thorstad; Ryan S Jackson Journal: JAMA Otolaryngol Head Neck Surg Date: 2020-01-01 Impact factor: 6.223
Authors: Jos M J A A Straetmans; Marijn Stuut; Martin Lacko; Frank Hoebers; Ernst-Jan M Speel; Bernd Kremer Journal: Head Neck Date: 2022-05-17 Impact factor: 3.821
Authors: Amy Dickinson; Mayank Saraswat; Stina Syrjänen; Tiialotta Tohmola; Robert Silén; Reija Randén-Brady; Timo Carpén; Jaana Hagström; Caj Haglund; Petri Mattila; Antti Mäkitie; Sakari Joenväärä; Suvi Silén Journal: PLoS One Date: 2020-06-15 Impact factor: 3.240