The association between T-stage and clinical nodal metastasis In HPV-positive oropharyngeal cancer

Ak, Sood; McIlwain, Wesley; O’Connell, Brendan P.; Nguyen, Shaun A.; Houlton, Jeffrey; Day, Terry A.

doi:10.1016/j.amjoto.2013.12.008

Cited by 21 publications

(22 citation statements)

References 34 publications

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“…When considering rate distributions by subsite within HPV‐positive and negative cohorts, its clinical significance is most evident in contralateral or bilateral nodal disease rates of HPV‐positive BOT tumors. Therefore, it seems that HPV‐positive midline tumors bear the highest likelihood for advanced nodal metastasis regardless of tumor classification, which is often cited as a significant confounder of contralateral or bilateral nodal disease . These lesions may warrant higher suspicion for contralateral nodal metastasis when considering the management of the neck.…”

Section: Discussionmentioning

confidence: 99%

Predictors of contralateral‐bilateral nodal disease in oropharyngeal cancer: A National Cancer Data Base Study

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Predictors of contralateral‐bilateral nodal disease in oropharyngeal cancer: A National Cancer Data Base Study

et al. 2017

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“…4 Neck metastases are found in 65% to 83% of patients on initial evaluation, and many patients with clinically negative necks have occult disease. 5 For HPVpositive tonsillar carcinoma, a recent retrospective analysis by Sood et al 6 has shown little relationship between tumor stage and nodal metastasis, although there is some correlation between tumor stage and distant disease. 6 Distant metastases are found in 15% to 30% of patients, with a predilection for lung involvement, followed by those of liver and bone.…”

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confidence: 99%

“…5 For HPVpositive tonsillar carcinoma, a recent retrospective analysis by Sood et al 6 has shown little relationship between tumor stage and nodal metastasis, although there is some correlation between tumor stage and distant disease. 6 Distant metastases are found in 15% to 30% of patients, with a predilection for lung involvement, followed by those of liver and bone. 7 The prognosis of OPSCCA has improved over time and is a direct result of HPV-related OPSCCA.…”

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confidence: 99%

Transoral Robotic Surgery in Oropharyngeal Carcinoma

Helman¹,

Schwedhelm²,

Kadakia³

et al. 2015

Archives of Pathology &Amp; Laboratory Medicine

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Context The incidence of oropharyngeal squamous cell carcinoma has increased during the past decade and is related primarily to the human papillomavirus. This change in etiology, from tobacco and alcohol to human papillomavirus, has resulted in improved survival for the disease. In the United States, open resection had largely been replaced by concurrent chemotherapy and/or radiotherapy by the early 2000s. The advent of transoral surgery has led to an increase in surgery as the primary treatment for both early- and advanced-stage oropharyngeal squamous cell carcinoma because it has potential advantages over open surgery and nonsurgical modalities. Objective To provide an overview of transoral robotic surgery for oropharyngeal squamous cell carcinoma and contrast it with other surgical and nonsurgical modalities. Data Sources Articles from 2000 to 2014 were accessioned on PubMed and reviewed for utility by the primary authors. Conclusions Transoral surgery has become more commonly used as a minimally invasive approach to treat oropharyngeal tumors. Other strategies, including radiation, chemotherapy with radiation, and open surgery, are still important treatment approaches. The treatment options for an individual patient rely on multiple factors, including the tumor location and size, features of the tumor, and patient comorbidities. The continued study of these techniques is important to match the patient with the most appropriate treatment.

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“…HPV‐positive tumours are more likely to be poorly differentiated and have well‐defined borders on radiological assessment and they often have better prognosis than non‐HPV tumours. Sood et al () found that the T staging in HPV‐positive tumours does not predict the presence of clinical nodal metastases but may predict the extent of neck disease. HPV‐positive base of tongue and tonsil cancers often have nodal disease at presentation and a relatively lower incidence of cN0 compared to other sites (Sood et al , ).…”

Section: Skip Metastases In the Cn0 Neckmentioning

confidence: 99%

An update on the latest evidence for managing the clinically negative neck (cN0) in oral squamous cell carcinoma

et al. 2016

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The single most important prognostic indicator for survival in oral squamous cell carcinoma (OSCC) is the presence of lymph node metastases in the neck. While the treatment of the clinically node positive (cN+) neck is well established, the management of the clinically negative neck (cN0) is controversial. Various strategies have been advocated including close observation including regular ultrasound imaging, elective neck dissection and sentinel lymph node biopsy. Neck dissection surgery is not without potential morbidity with shoulder dysfunction being the main complication. A number of factors are associated with increased risk of neck node metastasis including primary tumour thickness and peri-neural invasion. A recent prospective randomised trial has found survival benefit following neck dissection even in patients with a cN0 neck at presentation. We discuss the latest evidence for managing the cN0 in OSCC and include our own experience on the role of neck dissection in certain cases.

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The association between T-stage and clinical nodal metastasis In HPV-positive oropharyngeal cancer

Cited by 21 publications

References 34 publications

Predictors of contralateral‐bilateral nodal disease in oropharyngeal cancer: A National Cancer Data Base Study

Predictors of contralateral‐bilateral nodal disease in oropharyngeal cancer: A National Cancer Data Base Study

Transoral Robotic Surgery in Oropharyngeal Carcinoma

An update on the latest evidence for managing the clinically negative neck (cN0) in oral squamous cell carcinoma

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