Prognostic value of lymph node ratio versus American Joint Committee on Cancer N classification for surgically resected human papillomavirus-associated oropharyngeal squamous cell carcinoma.
Head Neck
; 43(5): 1476-1486, 2021 05.
Article
em En
| MEDLINE
| ID: mdl-33415799
ABSTRACT
BACKGROUND:
We compared prognostic values of lymph node ratio (LNR) and AJCC 8 N classification in surgically resected human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC).METHODS:
Using the National Cancer Database, we identified patients with HPV-associated OPSCC from 2010 to 2016 who underwent definitive surgical resection. Patients were analyzed by nodal grouping (LNR, N stage) and adjuvant radiation therapy(RT). Primary endpoint was overall survival.RESULTS:
We identified 4166 patients. Survival analysis showed significant improvement for LNR≤6% versus >6% (5 year OS% 92.7% vs. 83.7%, p < 0.001). N classification demonstrated good prognostic ability (5 year OS% for pN0, pN1, pN2 were 91.3%, 90.1%, 78.8%, p < 0.001), but poor separation among stages (compared to pN0 pN1 HR 1.40 [95% CI 0.63, 3.09], p = 0.41; pN2 HR 2.50 [95% CI 1.08, 5.81], p = 0.033). RT improved survival in the LNR > 6% group (5 year OS% 85.4% vs. 74.9%, p < 0.001; HR 0.41 [95% CI 0.28, 0.58], p < 0.001).CONCLUSIONS:
LNR should be considered an adjunct category in future staging systems for HPV-associated OPSCC.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Orofaríngeas
/
Alphapapillomavirus
/
Neoplasias de Cabeça e Pescoço
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article