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Title: 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

Abstract

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{sup 2}, Kruskal-Wallis, Mann-Whitney, and logistic regression analyses. Results: The rates of HPV/p16 positivity (P<.001), never-smoking (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 ofmore » 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.« less

Authors:
 [1];  [1];  [2];  [1]; ; ;  [2];  [3];  [4];  [3];  [1]
  1. Department of Radiation Oncology, University of Louisville, Louisville, Kentucky (United States)
  2. Department of Otolaryngology, University of Louisville, Louisville, Kentucky (United States)
  3. Division of Medical Oncology, Department of Medicine, University of Louisville, Louisville, Kentucky (United States)
  4. Department of Diagnostic Radiology, University of Louisville, Louisville, Kentucky (United States)
Publication Date:
OSTI Identifier:
22645651
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 96; Journal Issue: 2; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; LYMPH NODES; NEOPLASMS; PATIENTS; REGRESSION ANALYSIS; SMOKES; STRATIFICATION

Citation Formats

Amsbaugh, Mark J., E-mail: mjamsb01@louisville.edu, Yusuf, Mehran, Cash, Elizabeth, Silverman, Craig, Wilson, Elizabeth, Bumpous, Jeffrey, Potts, Kevin, Perez, Cesar, Bert, Robert, Redman, Rebecca, and Dunlap, Neal. 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. United States: N. p., 2016. Web. doi:10.1016/J.IJROBP.2016.06.2450.
Amsbaugh, Mark J., E-mail: mjamsb01@louisville.edu, Yusuf, Mehran, Cash, Elizabeth, Silverman, Craig, Wilson, Elizabeth, Bumpous, Jeffrey, Potts, Kevin, Perez, Cesar, Bert, Robert, Redman, Rebecca, & Dunlap, Neal. 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. United States. doi:10.1016/J.IJROBP.2016.06.2450.
Amsbaugh, Mark J., E-mail: mjamsb01@louisville.edu, Yusuf, Mehran, Cash, Elizabeth, Silverman, Craig, Wilson, Elizabeth, Bumpous, Jeffrey, Potts, Kevin, Perez, Cesar, Bert, Robert, Redman, Rebecca, and Dunlap, Neal. Sat . "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". United States. doi:10.1016/J.IJROBP.2016.06.2450.
@article{osti_22645651,
title = {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},
author = {Amsbaugh, Mark J., E-mail: mjamsb01@louisville.edu and Yusuf, Mehran and Cash, Elizabeth and Silverman, Craig and Wilson, Elizabeth and Bumpous, Jeffrey and Potts, Kevin and Perez, Cesar and Bert, Robert and Redman, Rebecca and Dunlap, Neal},
abstractNote = {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{sup 2}, Kruskal-Wallis, Mann-Whitney, and logistic regression analyses. Results: The rates of HPV/p16 positivity (P<.001), never-smoking (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.},
doi = {10.1016/J.IJROBP.2016.06.2450},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 96,
place = {United States},
year = {Sat Oct 01 00:00:00 EDT 2016},
month = {Sat Oct 01 00:00:00 EDT 2016}
}