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Outcomes of surgically treated human papillomavirus-related oropharyngeal squamous cell carcinoma with N3 disease. Laryngoscope 2017 Sep;127(9):2033-2037

Date

12/23/2016

Pubmed ID

28008626

DOI

10.1002/lary.26455

Scopus ID

2-s2.0-85007093238 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

OBJECTIVES/HYPOTHESIS: To evaluate outcomes for patients with pathological N3 (pN3) neck disease from human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) and determine variables predictive of survival.

STUDY DESIGN: Retrospective case series with chart review.

METHODS: This study was conducted between 1998 and 2013 and included patients with HPV-related OPSCC treated with surgery with or without adjuvant therapy and who had pN3 nodal disease. The primary outcome was disease-specific survival (DSS). Secondary outcomes included overall survival (OS), disease-free survival (DFS), adverse events, and gastrostomy tube rates.

RESULTS: Thirty-nine patients were included, of whom 36 (90%) underwent adjuvant therapy. Median follow-up was 39 months (range, 2-147 months). Mean age was 56 years, and 87% were male. Seventeen patients (44%) underwent selective neck dissection, whereas six (15%) underwent radical (n = 2) or extended radical (n = 4) neck dissection. Ninety-two percent had extracapsular extension. Five-year Kaplan-Meier estimated DSS, OS, and DFS were 89% (95% confidence interval [CI]: 79%-99%), 87% (95% CI: 75%-99%), and 84% (95% CI: 72%-96%), respectively. The disease recurrence rate was 10% (5% regional, 5% distant metastasis). Patients with less than 5 pathologically positive lymph nodes (P = .041) had improved DFS.

CONCLUSIONS: Patients with HPV-related OPSCC and pN3 nodal disease treated with surgery and adjuvant therapy have very favorable long-term survival and regional control. Patients with five or more pathologically positive lymph nodes may be at higher risk for recurrence.

LEVEL OF EVIDENCE: 4. Laryngoscope, 127:2033-2037, 2017.

Author List

Zenga J, Haughey BH, Jackson RS, Adkins DR, Aranake-Chrisinger J, Bhatt N, Gay HA, Kallogjeri D, Martin EJ, Moore EJ, Paniello RC, Rich JT, Thorstad WL, Nussenbaum B

Author

Joseph Zenga MD Assistant Professor in the Otolaryngology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Carcinoma, Squamous Cell
Chemotherapy, Adjuvant
Disease-Free Survival
Female
Gastrostomy
Humans
Kaplan-Meier Estimate
Lymph Nodes
Male
Middle Aged
Neck
Neck Dissection
Oropharyngeal Neoplasms
Papillomaviridae
Papillomavirus Infections
Postoperative Period
Retrospective Studies
Survival Rate
Treatment Outcome