BACKGROUND: The objective of the current study was to characterize the incidence, pattern, and impact on oncologic outcomes of retropharyngeal lymph node (RPLN) involvement in HPV-associated oropharyngeal cancer (OPC). METHODS: Data regarding patients with HPV-associated OPC who were treated at The University of Texas MD Anderson Cancer Center with intensity-modulated radiotherapy from 2004 through 2013 were analyzed retrospectively. RPLN status was determined by reviewing pretreatment imaging and/or reports. Outcomes analysis was restricted to patients with lymph node-positive (+) disease. Kaplan-Meier survival estimates were generated and survival curves were compared using the log-rank test. Bayesian information criterion assessed model performance changes with the addition of RPLN status to current American Joint Committee on Cancer staging. Competing risk analysis compared modes of disease recurrence. RESULTS: The incidence of radiographic RPLN involvement was 9% (73 of 796 patients) and was found to vary by primary tumor site. The 5-year rates of freedom from distant metastases (FDM) and overall survival were lower in patients with RPLN(+) status compared with those with RPLN-negative (-) status (84% vs 93% [P = .0327] and 74% vs 87% [P = .0078], respectively). RPLN(+) status was not found to be associated with outcomes on multivariate analysis. Bayesian information criterion analysis demonstrated that current American Joint Committee on Cancer staging was not improved with the inclusion of RPLN. Locoregional and distant disease recurrence probabilities for those patients with RPLN(+) status were 8% and 13%, respectively, compared with 10% and 6%, respectively, for those with RPLN(-) status. RPLN(+) status portended worse 5-year FDM in the low-risk subgroup (smoking history of <10 pack-years) and among patients who received concurrent chemotherapy but not induction chemotherapy. CONCLUSIONS: RPLN(+) status was associated with worse overall survival and FDM on univariate but not multivariate analysis. In subgroup analyses, RPLN(+) status was associated with poorer FDM in both patients with a smoking history of <10 pack-years and those who received concurrent chemotherapy, suggesting that RPLN(+) status could be considered an exclusion criteria in treatment deintensification efforts seeking to omit chemotherapy.
BACKGROUND: The objective of the current study was to characterize the incidence, pattern, and impact on oncologic outcomes of retropharyngeal lymph node (RPLN) involvement in HPV-associated oropharyngeal cancer (OPC). METHODS: Data regarding patients with HPV-associated OPC who were treated at The University of Texas MD Anderson Cancer Center with intensity-modulated radiotherapy from 2004 through 2013 were analyzed retrospectively. RPLN status was determined by reviewing pretreatment imaging and/or reports. Outcomes analysis was restricted to patients with lymph node-positive (+) disease. Kaplan-Meier survival estimates were generated and survival curves were compared using the log-rank test. Bayesian information criterion assessed model performance changes with the addition of RPLN status to current American Joint Committee on Cancer staging. Competing risk analysis compared modes of disease recurrence. RESULTS: The incidence of radiographic RPLN involvement was 9% (73 of 796 patients) and was found to vary by primary tumor site. The 5-year rates of freedom from distant metastases (FDM) and overall survival were lower in patients with RPLN(+) status compared with those with RPLN-negative (-) status (84% vs 93% [P = .0327] and 74% vs 87% [P = .0078], respectively). RPLN(+) status was not found to be associated with outcomes on multivariate analysis. Bayesian information criterion analysis demonstrated that current American Joint Committee on Cancer staging was not improved with the inclusion of RPLN. Locoregional and distant disease recurrence probabilities for those patients with RPLN(+) status were 8% and 13%, respectively, compared with 10% and 6%, respectively, for those with RPLN(-) status. RPLN(+) status portended worse 5-year FDM in the low-risk subgroup (smoking history of <10 pack-years) and among patients who received concurrent chemotherapy but not induction chemotherapy. CONCLUSIONS: RPLN(+) status was associated with worse overall survival and FDM on univariate but not multivariate analysis. In subgroup analyses, RPLN(+) status was associated with poorer FDM in both patients with a smoking history of <10 pack-years and those who received concurrent chemotherapy, suggesting that RPLN(+) status could be considered an exclusion criteria in treatment deintensification efforts seeking to omit chemotherapy.
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: Elisa Tardini; Xinhua Zhang; Guadalupe Canahuate; Andrew Wentzel; Abdallah S R Mohamed; Lisanne Van Dijk; Clifton D Fuller; G Elisabeta Marai Journal: J Med Internet Res Date: 2022-04-20 Impact factor: 7.076
Authors: Hesham Elhalawani; Carlos E Cardenas; Stefania Volpe; Souptik Barua; Sonja Stieb; Calvin B Rock; Timothy Lin; Pei Yang; Haijun Wu; Jhankruti Zaveri; Baher Elgohari; Lamiaa E Abdallah; Amit Jethanandani; Abdallah S R Mohamed; Laurence E Court; Katherine A Hutcheson; G Brandon Gunn; David I Rosenthal; Steven J Frank; Adam S Garden; Arvind Rao; Clifton D Fuller Journal: Clin Transl Radiat Oncol Date: 2021-06-06
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
Authors: Yue Cao; Madhava Aryal; Pin Li; Choonik Lee; Matthew Schipper; Peter G Hawkins; Christina Chapman; Dawn Owen; Aleksandar F Dragovic; Paul Swiecicki; Keith Casper; Francis Worden; Theodore S Lawrence; Avraham Eisbruch; Michelle Mierzwa Journal: Front Oncol Date: 2019-11-14 Impact factor: 6.244