Predicting Residual Neck Disease in Patients With Oropharyngeal Squamous Cell Carcinoma Treated With Radiation Therapy

Shonka, David C.; Shoushtari, A.; Thomas, Christopher Y.; Moskaluk, Christopher A.; Read, Paul W.; Reibel, James F.; Levine, Paul A.; Jameson, Mark J.

doi:10.1001/archoto.2009.153

Cited by 22 publications

(22 citation statements)

References 22 publications

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“…According to a recent investigation patients with HPVrelated tumors are less likely to have a pathological positive PND [55] but a positive PND represents a biological unfavorable subset of the HPV population with reduced survival possibly attributable to distant metastases [56].…”

Section: Discussionmentioning

confidence: 99%

No benefit for regional control and survival by planned neck dissection in primary irradiated oropharyngeal cancer irrespective of p16 expression

Maquieira

Haerle

Huber

et al. 2015

Eur Arch Otorhinolaryngol

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The aim of the study was to assess regional control and survival in primary irradiated oropharyngeal cancer patients with advanced neck disease (≥cN2a) receiving planned neck dissection (PND) irrespective of the nodal response compared to salvage neck dissection (SND) in case of regional persistence or reccurence in relation to tumoral p16 overexpression. 96 consecutive patients treated at the University Hospital of Zurich, Switzerland were included. Tissue microarray-based scoring of p16 expression was obtained. 5 years overall (OS) and disease-specific survival (DSS) in the PND and SND cohort were 70 vs. 57 % (p = 0.20) and 80 vs. 65 % (p = 0.14), respectively. Regional control in PND and SND achieved 95 vs. 87 % (p = 0.29), respectively. There was no statistically significant impact of neck treatment (PND vs. SND) on regional control or survival among patients with p16-negative tumors (5 years OS 59 vs. 50 %, p = 0.66; 5 years DSS 59 vs. 57 %, p = 0.89) nor among patients with p16-positive tumors (5 years OS 84 vs. 67 %, p = 0.21; 5 years DSS 95 vs. 81 %, p = 0.24). The type of neck dissection after primary intensity-modulated radiotherapy (IMRT) had no impact on regional control and survival even in human papillomavirus (HPV)-associated disease. Therefore we are convinced that based on the accuracy of newer diagnostic modalities the surveillance of a radiologically negative neck after primary chemoradiation (CRT) is oncologically safe irrespective of p16 expression of the tumor.

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Section: Discussionmentioning

confidence: 99%

No benefit for regional control and survival by planned neck dissection in primary irradiated oropharyngeal cancer irrespective of p16 expression

Maquieira

Haerle

Huber

et al. 2015

Eur Arch Otorhinolaryngol

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“…14,15 Patients with T1-2 p16ϩ tonsillar SCC presented with radiographic evidence of contralateral nodal spread with an incidence of 25.0% compared with 0% for p16Ϫ tumors (P ϭ 0.05), despite having no clinical or radiographic evidence of invasion outside the tonsillar fossa into tissues that have bilateral lymphatic drainage, such as the soft palate or base of tongue. This incidence of contralateral nodal spread is higher than what prior studies have reported for patients with early tonsillar primaries.…”

Section: Discussionmentioning

confidence: 99%

“…Despite current data showing a difference in prognosis for patients with HPVϩ disease in smokers and nonsmokers, our dataset was too small to show a difference. 14 Our aim in publishing this initial data is to report the early observational difference in spread patterns among early-stage tonsillar SCC in p16ϩ versus p16Ϫ disease at our institution. Clearly, this information may change treatment recommendations if validated in a larger cohort of patients.…”

Section: Discussionmentioning

confidence: 99%

“…13 It has further been reported that patients with p16ϩ oropharyngeal tumors present with higher nodal stage than patients with p16Ϫ tumors. 14,15 Based on several supportive studies, there has been a recent trend toward ipsilateral cervical nodal irradiation for well-lateralized, early-stage tonsillar SCC. [1][2][3][4] However, many of the data used to justify this approach was collected between the late 1950s through the early 1990s before the sharp rise in HPV-associated tumors.…”

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confidence: 99%

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Clinical Nodal Staging of T1-2 Tonsillar Squamous Cell Carcinoma Stratified by p16 Status and Implications for Ipsilateral Neck Irradiation

Shoushtari¹,

Meeneghan²,

Treharne³

et al. 2010

The Cancer Journal

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“…HPV status might be also considered in the indication of adjuvant therapy. It has been shown that p16 status as surrogate marker of HPV infection together with other clinical parameters successfully predicted the need of neck dissection after radiotherapy [42].…”

Section: Clinical Impactmentioning

confidence: 99%

Human papillomavirus in head and neck tumors: epidemiological, molecular and clinical aspects

Klozar

Tachezy

Rotnáglová

et al. 2010

Wien Med Wochenschr

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High-risk types of human papillomaviruses (HR HPV) play an important role in the etiology of a group of head and neck squamous cell cancers (HNSCC). This review is focused on epidemiological, molecular, and clinical aspects of HPV infection in head and neck cancer. High risk HPV DNA is being detected in a very different proportion of HNSCC with the highest prevalence in oropharynx. Patients with HPV-associated tumors are characterized by moderate tobacco and alcohol consumption. Some aspects of sexual behavior may represent a risk factor. Recently, it has been shown that HPV infection is spreading and the rising prevalence of HPV-positive tumors can probably be attributed to this epidemic. On molecular level the viral oncoproteins E6 and E7 were shown to be involved in oncogenesis. HPV-positive cancers have better prognosis and HPV status should be considered in clinical decision-making. The rising proportion of HPV-positive tumors underlines the importance of HPV vaccination also for the prevention of HNSCC.

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Predicting Residual Neck Disease in Patients With Oropharyngeal Squamous Cell Carcinoma Treated With Radiation Therapy

Cited by 22 publications

References 22 publications

No benefit for regional control and survival by planned neck dissection in primary irradiated oropharyngeal cancer irrespective of p16 expression

No benefit for regional control and survival by planned neck dissection in primary irradiated oropharyngeal cancer irrespective of p16 expression

Clinical Nodal Staging of T1-2 Tonsillar Squamous Cell Carcinoma Stratified by p16 Status and Implications for Ipsilateral Neck Irradiation

Human papillomavirus in head and neck tumors: epidemiological, molecular and clinical aspects

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