Stuart E Samuels1, Jeffrey Vainshtein1, Matthew E Spector2, Mohannad Ibrahim3, Jonathan B McHugh4, Yebin Tao5, Matthew Schipper1, Francis Worden6, Avraham Eisbruch7. 1. Department of Radiation Oncology, University of Michigan, United States. 2. Department of Otorhinolaryngology-Head Neck Surgery, University of Michigan, United States. 3. Department of Radiology, University of Michigan, United States. 4. Department of Pathology, University of Michigan, United States. 5. Department of Biostatistics, University of Michigan, United States. 6. Department of Medicine - Medical Oncology Division, University of Michigan, United States. 7. Department of Radiation Oncology, University of Michigan, United States. Electronic address: Eisbruch@umich.edu.
Abstract
PURPOSE: Retropharyngeal adenopathy (RPA) is poor prognostic factor in head and neck (HN) cancer. However, the prognostic significance of RPA in Human Papillomavirus-related (HPV+) oropharyngeal cancer (OPC) is unknown. PATIENTS AND METHODS: 185 patients with HPV+OPC were assessed. Pre-therapy images reviewed by a HN radiologist to determine presence of RPA. Doses to the RPAs were determined from treatment plans. Outcomes analyzed using Kaplan-Meier method, log-rank tests, and correlations determined using Spearman's rank analyses. RESULTS: 29 (16%) of the HPV+patients had RPA. At median follow-up 49months, 5-year overall survival (OS), failure-free survival (FFS) and distant failure-free survival (DFFS) were 57% vs. 81% (P=0.02), 63% vs 80% (P=0.015) and 70% vs 91% (P=0.002) for patients with/without RPA, respectively. No differences observed in local/ regional control rates, exceeding 90% in both groups, and No RPA recurrences were observed. In multivariable analysis, stages T4 or N3, and RPA, were independently, statistically significantly associated with both OS and distant failure, while N2c, age, disease site, and smoking status, were not. CONCLUSION: RPA in HPV+OPC is an independent prognostic factor for distant failure, translating into worse OS. Patients with RPA may not be suitable candidates for trials of systemic treatment de-escalation.
PURPOSE:Retropharyngeal adenopathy (RPA) is poor prognostic factor in head and neck (HN) cancer. However, the prognostic significance of RPA in Human Papillomavirus-related (HPV+) oropharyngeal cancer (OPC) is unknown. PATIENTS AND METHODS: 185 patients with HPV+OPC were assessed. Pre-therapy images reviewed by a HN radiologist to determine presence of RPA. Doses to the RPAs were determined from treatment plans. Outcomes analyzed using Kaplan-Meier method, log-rank tests, and correlations determined using Spearman's rank analyses. RESULTS: 29 (16%) of the HPV+patients had RPA. At median follow-up 49months, 5-year overall survival (OS), failure-free survival (FFS) and distant failure-free survival (DFFS) were 57% vs. 81% (P=0.02), 63% vs 80% (P=0.015) and 70% vs 91% (P=0.002) for patients with/without RPA, respectively. No differences observed in local/ regional control rates, exceeding 90% in both groups, and No RPA recurrences were observed. In multivariable analysis, stages T4 or N3, and RPA, were independently, statistically significantly associated with both OS and distant failure, while N2c, age, disease site, and smoking status, were not. CONCLUSION: RPA in HPV+OPC is an independent prognostic factor for distant failure, translating into worse OS. Patients with RPA may not be suitable candidates for trials of systemic treatment de-escalation.
Authors: Piet Dirix; Sandra Nuyts; Barbara Bussels; Robert Hermans; Walter Van den Bogaert Journal: Int J Radiat Oncol Biol Phys Date: 2006-07-01 Impact factor: 7.038
Authors: Barbara Bussels; Robert Hermans; Alex Reijnders; Piet Dirix; Sandra Nuyts; Walter Van den Bogaert Journal: Int J Radiat Oncol Biol Phys Date: 2006-07-01 Impact factor: 7.038
Authors: Vincent Grégoire; Kian Ang; Wilfried Budach; Cai Grau; Marc Hamoir; Johannes A Langendijk; Anne Lee; Quynh-Thu Le; Philippe Maingon; Chris Nutting; Brian O'Sullivan; Sandro V Porceddu; Benoit Lengele Journal: Radiother Oncol Date: 2013-10-31 Impact factor: 6.280
Authors: Jessica H Maxwell; Bhavna Kumar; Felix Y Feng; Francis P Worden; Julia S Lee; Avraham Eisbruch; Gregory T Wolf; Mark E Prince; Jeffrey S Moyer; Theodoros N Teknos; Douglas B Chepeha; Jonathan B McHugh; Susan G Urba; Jay Stoerker; Heather M Walline; David M Kurnit; Kitrina G Cordell; Samantha J Davis; Preston D Ward; Carol R Bradford; Thomas E Carey Journal: Clin Cancer Res Date: 2010-02-09 Impact factor: 12.531
Authors: Carole Fakhry; William H Westra; Sigui Li; Anthony Cmelak; John A Ridge; Harlan Pinto; Arlene Forastiere; Maura L Gillison Journal: J Natl Cancer Inst Date: 2008-02-12 Impact factor: 13.506
Authors: Joel A Ernster; Cosimo G Sciotto; Maureen M O'Brien; Jack L Finch; Linda J Robinson; Thomas Willson; Michael Mathews Journal: Laryngoscope Date: 2007-12 Impact factor: 3.325
Authors: Avraham Eisbruch; Lon H Marsh; Laura A Dawson; Carol R Bradford; Theodoros N Teknos; Douglas B Chepeha; Francis P Worden; Susan Urba; Alexander Lin; Matthew J Schipper; Gregory T Wolf Journal: Int J Radiat Oncol Biol Phys Date: 2004-05-01 Impact factor: 7.038
Authors: Felix Y Feng; Hyungjin M Kim; Teresa H Lyden; Marc J Haxer; Mary Feng; Frank P Worden; Douglas B Chepeha; Avraham Eisbruch Journal: Int J Radiat Oncol Biol Phys Date: 2007-06-07 Impact factor: 7.038
Authors: M P McLaughlin; W M Mendenhall; A A Mancuso; J T Parsons; P J McCarty; N J Cassisi; S P Stringer; R P Tart; S K Mukherji; R R Million Journal: Head Neck Date: 1995 May-Jun Impact factor: 3.147
Authors: Kee H Wong; Rafal Panek; Shreerang A Bhide; Christopher M Nutting; Kevin J Harrington; Katie L Newbold Journal: Br J Radiol Date: 2017-03 Impact factor: 3.039
Authors: George Garas; Nick J Roland; Jeffrey Lancaster; Matthew Zammit; Victoria A Manon; Katharine Davies; Terry M Jones; Mriganka De; Floyd C Holsinger; Robin J D Prestwich; Jason C Fleming Journal: Ann Surg Oncol Date: 2022-07-16 Impact factor: 4.339
Authors: Stuart E Samuels; Yebin Tao; Teresa Lyden; Marc Haxer; Matthew Spector; Kelly M Malloy; Mark E Prince; Carol R Bradford; Francis P Worden; Matthew Schipper; Avraham Eisbruch Journal: Oral Oncol Date: 2016-01-06 Impact factor: 5.337
Authors: Stuart E Samuels; Avraham Eisbruch; Jonathan J Beitler; June Corry; Carol R Bradford; Nabil F Saba; Michiel W M van den Brekel; Robert Smee; Primož Strojan; Carlos Suárez; William M Mendenhall; Robert P Takes; Juan P Rodrigo; Missak Haigentz; Alexander D Rapidis; Alessandra Rinaldo; Alfio Ferlito Journal: Eur Arch Otorhinolaryngol Date: 2015-10-13 Impact factor: 3.236
Authors: Rajat Banerjee; Min Liu; Emily Bellile; Ligia B Schmitd; Mitsuo Goto; Marsha-Kay N D Hutchinson; Priyanka Singh; Shuang Zhang; Dilna P V Damodaran; Mukesh K Nyati; Matthew E Spector; Brent Ward; Gregory Wolf; Keith Casper; Michelle Mierzwa; Nisha J D'Silva Journal: Mol Ther Date: 2021-06-08 Impact factor: 11.454
Authors: Zsuzsanna Iyizoba-Ebozue; Louise J Murray; Moses Arunsingh; Karen E Dyker; Sriram Vaidyanathan; Andrew F Scarsbrook; Robin J D Prestwich Journal: Cancers (Basel) Date: 2019-12-29 Impact factor: 6.639