Volume 35, Issue 10 pp. 1454-1460

Original Article

Residual nodal disease in patients with advanced-stage oropharyngeal squamous cell carcinoma treated with definitive radiation therapy and posttreatment neck dissection: Association with locoregional recurrence, distant metastasis, and decreased survival

Vlad C. Sandulache MD, PhD,

Vlad C. Sandulache MD, PhD

Bobby R. Alford Department of Otolaryngology–Head and Neck Surgery, Baylor College of Medicine, Houston, Texas

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Thomas J. Ow MD,

Thomas J. Ow MD

Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas

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Shiva P. Daram BS,

Shiva P. Daram BS

Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas

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Jackson Hamilton MD,

Jackson Hamilton MD

Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas

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Heath Skinner MD, PhD,

Heath Skinner MD, PhD

Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas

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Diana Bell MD,

Diana Bell MD

Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas

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David I. Rosenthal MD,

David I. Rosenthal MD

Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas

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Beth M. Beadle MD, PhD,

Beth M. Beadle MD, PhD

Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas

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K. Kian Ang MD, PhD,

K. Kian Ang MD, PhD

Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas

DeceasedSearch for more papers by this author

Merrill S. Kies MD,

Merrill S. Kies MD

Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas

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Faye M. Johnson MD, PhD,

Faye M. Johnson MD, PhD

Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas

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Adel K. El-Naggar MD, PhD,

Adel K. El-Naggar MD, PhD

Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas

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Jeffrey N. Myers MD, PhD,

Corresponding Author

Jeffrey N. Myers MD, PhD

Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas

Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas. E-mail: [email protected]Search for more papers by this author

Vlad C. Sandulache MD, PhD,

Vlad C. Sandulache MD, PhD

Bobby R. Alford Department of Otolaryngology–Head and Neck Surgery, Baylor College of Medicine, Houston, Texas

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Thomas J. Ow MD,

Thomas J. Ow MD

Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas

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Shiva P. Daram BS,

Shiva P. Daram BS

Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas

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Jackson Hamilton MD,

Jackson Hamilton MD

Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas

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Heath Skinner MD, PhD,

Heath Skinner MD, PhD

Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas

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Diana Bell MD,

Diana Bell MD

Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas

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David I. Rosenthal MD,

David I. Rosenthal MD

Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas

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Beth M. Beadle MD, PhD,

Beth M. Beadle MD, PhD

Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas

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K. Kian Ang MD, PhD,

K. Kian Ang MD, PhD

Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas

DeceasedSearch for more papers by this author

Merrill S. Kies MD,

Merrill S. Kies MD

Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas

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Faye M. Johnson MD, PhD,

Faye M. Johnson MD, PhD

Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas

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Adel K. El-Naggar MD, PhD,

Adel K. El-Naggar MD, PhD

Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas

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Jeffrey N. Myers MD, PhD,

Corresponding Author

Jeffrey N. Myers MD, PhD

Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas

Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas. E-mail: [email protected]Search for more papers by this author

First published: 28 September 2012

https://doi.org/10.1002/hed.23173

Citations: 13

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Abstract

Background

Oropharyngeal squamous cell carcinoma (OPSCC) is increasing in frequency. We reviewed patients with advanced-stage OPSCC treated with chemoradiation to assess the impact of residual neck disease on survival.

Methods

We reviewed 202 patients with OPSCC between 1990 and 2010 treated with primary chemoradiation followed by neck dissection. Imaging was analyzed using RECIST (Response Evaluation Criteria In Solid Tumors) 1.1 criteria. Survival was evaluated using both univariate and multivariate analyses.

Results

Overall survival at 5 years was 89%. Forty-two patients (21%) had residual disease in the neck (pN+). pN+ was associated with greater locoregional recurrence (LRR) and distant metastasis (DM) and decreased survival. No clinicopathologic factors were predictive of pN+. Contrasted posttreatment CT had low sensitivity and specificity.

Conclusions

In advanced OPSCC pN+, patients have higher rates of LRR and DM. Neither clinicopathologic factors nor posttreatment imaging was predictive of pN+, although increased use of modern imaging may reduce the rate of negative neck dissections. © 2012 Wiley Periodicals, Inc. Head Neck 35: 1454–1460, 2013

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Citing Literature

Volume35, Issue10

October 2013

Pages 1454-1460

Residual nodal disease in patients with advanced-stage oropharyngeal squamous cell carcinoma treated with definitive radiation therapy and posttreatment neck dissection: Association with locoregional recurrence, distant metastasis, and decreased survival

Abstract

Background

Methods

Results

Conclusions

REFERENCES

Citing Literature

References

Information

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Residual nodal disease in patients with advanced-stage oropharyngeal squamous cell carcinoma treated with definitive radiation therapy and posttreatment neck dissection: Association with locoregional recurrence, distant metastasis, and decreased survival

Abstract

Background

Methods

Results

Conclusions

REFERENCES

Citing Literature

References

Related

Information