Distribution of Cervical Lymph Node Metastases From Squamous Cell Carcinoma of the Oropharynx in the Era of Risk Stratification Using Human Papillomavirus and Smoking Status
| Autor: | Craig L. Silverman, Neal Dunlap, Cesar A. Perez, Rebecca Redman, Elizabeth Cash, Elizabeth Wilson, Robert J. Bert, Jeffrey M. Bumpous, Mehran Yusuf, Mark J. Amsbaugh, K. Potts |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty Kentucky Comorbidity Risk Assessment Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Tongue Internal medicine Vallecula Prevalence Carcinoma Humans Medicine Radiology Nuclear Medicine and imaging 030223 otorhinolaryngology Papillomaviridae Lymph node Aged Aged 80 and over Radiation Squamous Cell Carcinoma of Head and Neck business.industry Papillomavirus Infections Smoking Reproducibility of Results Odds ratio Middle Aged medicine.disease Oropharyngeal Neoplasms medicine.anatomical_structure Head and Neck Neoplasms Lymphatic Metastasis 030220 oncology & carcinogenesis Tonsil Carcinoma Squamous Cell Female Sentinel Lymph Node business Risk assessment Neck |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 96:349-353 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2016.06.2450 |
| Popis: | Purpose/Objective(s) To investigate the factors contributing to the clinical presentation of oropharyngeal squamous cell carcinoma (OPSCC) in the era of risk stratification using human papilloma virus (HPV) and smoking status. Methods and Materials All patients with OPSCC presenting to our institutional multidisciplinary clinic from January 2009 to June 2015 were reviewed from a prospective database. The patients were grouped as being at low risk, intermediate risk, and high risk in the manner described by Ang et al. Variance in clinical presentation was examined using χ 2 , Kruskal-Wallis, Mann-Whitney, and logistic regression analyses. Results The rates of HPV/p16 positivity ( P P =.016), and cervical lymph node metastases ( P =.023) were significantly higher for patients with OPSCC of the tonsil, base of tongue (BOT), or vallecula subsites when compared with pharyngeal wall or palate subsites. Low-risk patients with tonsil, base of tongue, or vallecula primary tumors presented with nodal stage N2a at a much higher than expected frequency ( P =.007), and high-risk patients presented with tumor stage T4 at a much higher than expected frequency ( P =.003). Patients with BOT primary tumors who were never-smokers were less likely to have clinically involved ipsilateral neck disease than were former smokers (odds ratio 1.8; P =.038). The distribution of cervical lymph node metastases was not associated with HPV/p16 positivity, risk group, or subsite. When these data were compared with those in historical series, no significant differences were seen in the patterns of cervical lymph node metastases for patients with OPSCC. Conclusions For patients with OPSCC differences in HPV status, smoking history and anatomic subsite were associated with differences in clinical presentation but not with distribution of cervical lymph node metastases. Historical series describing the patterns of cervical lymph node metastases in patients with OPSCC remain clinically relevant. |
| Databáze: | OpenAIRE |
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