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Morphologic and topographic radiologic features of human papillomavirus‐related and –unrelated oropharyngeal carcinoma
Author(s) -
Chan Michael W.,
Yu Eugene,
Bartlett Eric,
O'Sullivan Brian,
Su Jie,
Waldron John,
Ringash Jolie,
Bratman Scott V.,
Chen Yingming Amy,
Irish Jonathan,
Kim John,
Gullane Patrick,
Gilbert Ralph,
Chepeha Douglas,
PerezOrdonez Bayardo,
Weinreb Ilan,
Hansen Aaron,
Tong Li,
Xu Wei,
Huang Shao Hui
Publication year - 2017
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24764
Subject(s) - concordance , medicine , lymph node , nomogram , human papillomavirus , lymph , pathology , radiology , oncology
Abstract Background The purpose of this study was to compare the clinicoradiologic characteristics of human papillomavirus (HPV)‐related (HPV‐positive) and HPV‐unrelated (HPV‐negative) oropharyngeal carcinoma (OPC). Methods Primary tumor and lymph node features of HPV‐positive and HPV‐negative OPCs from 2008 to 2013 were compared on pretreatment CT/MRI. Intrarater/interrater concordance was assessed. Multivariable analyses identified factors associated with HPV‐positivity to be used in nomogram construction. Results Compared to HPV‐negative (n = 194), HPV‐positive (n = 488) tumors were more exophytic (73% vs 63%; p = .02) with well‐defined border (58% vs 47%; p = .033) and smaller axial dimensions; lymph node involvement predominated (89% vs 69%; p < .001) with cystic appearance (45% vs 32%; p = .009) but similar topography. Intrarater/interrater concordance varied (fair to excellent). Nomograms combining clinical (age, sex, smoking pack‐years, subsite, T/N classification) and/or radiologic (nonnecrotic tumor and cystic lymph node) features were used to weigh the likelihood of HPV‐driven tumors (area under the curve [AUC] = 0.84). Conclusion HPV‐positive OPC has different radiologic tumor (exophytic/well‐defined border/smaller axial dimension) and lymph node (cystic) features but similar lymph node topography.