AJCC-8ed nodal staging does not predict outcomes in surgically managed HPV-associated oropharyngeal cancer.
Publication/Presentation Date
7-1-2018
Abstract
OBJECTIVE: To assess the pathological outcomes of surgically-managed human papillomavirus (HPV) positive oropharyngeal squamous cell carcinoma (OPSCC) using the 8th Edition of the American Joint Committee on Cancer Staging Manual (AJCC-8ed).
MATERIALS AND METHODS: A retrospective review was conducted of 156 patients with previously untreated OPSCC who underwent primary TORS between March 2010 and February 2015 to evaluate the impact of the new AJCC-8ed pathologic staging system. Only patients who had complete pathologic staging with neck dissection and at least 2 years of follow-up records or disease recurrence within 2 years were included for analysis.
RESULTS AND CONCLUSIONS: Of the 156 patients, 116 patients had neck dissections and adequate follow-up data. There were 10 total recurrences, including 2 regional recurrences and 1 local recurrence. Lymph node size, number of positive lymph nodes, and presence of any positive nodes were not associated with recurrence for HPV-positive patients. The presence of extranodal extension approached significance. Pathologic N-stage was not predictive of recurrence under the AJCC-7ed or the AJCC-8ed systems. Cancer staging under the AJCC-8ed, but not the AJCC-7ed system was significantly associated with recurrence. In conclusion, pathologic node status as defined in the AJCC-8ed pathologic staging system does not appear to drive prognosis for surgically managed patients. While the new AJCC-8ed staging is an improvement in prognostication, the use of T-stage alone is still a better predictor of recurrence. TORS with adjuvant therapy determined by pathologic findings provides excellent locoregional control for HPV-positive OPSCC.
Volume
82
First Page
138
Last Page
143
ISSN
1879-0593
Published In/Presented At
Hobelmann, K. C., Topf, M. C., Bar-Ad, V., Luginbuhl, A. J., Keane, W. M., Curry, J. M., & Cognetti, D. M. (2018). AJCC-8ed nodal staging does not predict outcomes in surgically managed HPV-associated oropharyngeal cancer. Oral oncology, 82, 138–143. https://doi.org/10.1016/j.oraloncology.2018.05.016
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
29909888
Department(s)
Administration and Leadership
Document Type
Article