The prognostic effect of radiological extranodal extension in HPV-positive oropharyngeal squamous cell carcinomas: a retrospective cohort analysis.

Autor: Meulemans J; Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. jeroen.meulemans@uzleuven.be.; Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium. jeroen.meulemans@uzleuven.be., Werpin L; Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium., Hermans R; Radiology, University Hospitals Leuven, Leuven, Belgium., Laenen A; Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Leuven, Belgium., Nuyts S; Laboratory of Experimental Radiotherapy, Department of Oncology, KU Leuven, Leuven, Belgium.; Radiation Oncology, University Hospitals Leuven, Leuven, Belgium., Clement PM; Medical Oncology, University Hospitals Leuven, Leuven, Belgium., Delaere P; Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium., Van Lierde C; Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.; Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium., Vander Poorten V; Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.; Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium.
Jazyk: angličtina
Zdroj: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery [Eur Arch Otorhinolaryngol] 2024 Mar; Vol. 281 (3), pp. 1541-1558. Date of Electronic Publication: 2024 Jan 03.
DOI: 10.1007/s00405-023-08409-8
Abstrakt: Purpose: Radiological extranodal extension (rENE) is a well-known negative prognosticator in head and neck squamous cell carcinoma (HNSCC). However, controversy remains regarding the prognostic effect of rENE in HPV-positive oropharyngeal SCCs (OPSCC). This single-center retrospective cohort analysis assessed the prognostic role of rENE in an HPV + OPSCC population and tried to validate a recently proposed modification of the TNM8 N-classification.
Methods: 129 patients with HPV + OPSCC, of whom 106 cN + patients, were included. Radiological imaging (CT, MRI or both) was reanalyzed by a senior head and neck radiologist. Overall survival (OS), disease-free survival (DFS), locoregional recurrence-free survival (LRFS), and disease-specific survival (DSS) were evaluated. Cox proportional hazard models were used for estimating hazard ratios (HR).
Results: A non-significant trend towards better outcomes in the rENE- group, as compared to the rENE + population, was observed for 5 year OS [80.99% vs 68.70%, HR: 2.05, p = 0.160], 5 year RFS [78.81% vs 67.87%, HR: 1.91, p = 0.165], 5 year DFS [77.06% vs 60.16%, HR: 2.12, p = 0.0824] and 5 year DSS [88.83% vs 81.93%, HR: 2.09, p = 0.195]. OS declined with ascending levels of rENE (p = 0.020). Multivariate analysis identified cT-classification and smoking as independent negative predictors for OS/DFS. The proposed modification of the TNM8 N-classification could not be validated.
Conclusions: Although rENE could not be identified as an independent negative prognosticator for outcome in our HPV + OPSCC population, outcomes tend to deteriorate with increasing rENE.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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