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Oncologic outcomes of extended neck dissections in human papillomavirus‐related oropharyngeal squamous cell carcinoma
Author(s) -
Zenga Joseph,
Pipkorn Patrik,
Graboyes Evan M.,
Martin Eliot J.,
Rich Jason T.,
Moore Eric J.,
Haughey Bruce H.,
Jackson Ryan S.
Publication year - 2018
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.25060
Subject(s) - medicine , neurovascular bundle , radiation therapy , pathological , neck dissection , oncology , chemotherapy , adjuvant radiotherapy , cancer , surgery
Background Oncologic outcomes of human papillomavirus (HPV)‐related oropharyngeal squamous cell carcinoma (SCC) requiring resection of major muscular or neurovascular tissue during neck dissection for invasive nodal disease remain uncertain. Methods Patients with HPV‐related oropharyngeal SCC requiring resection of major muscular or neurovascular tissue during their neck dissections were retrospectively identified. Results Seventy‐two patients were included. Regional and distant recurrences occurred in 6% and 17% of patients. Advanced T classification, pathological node number of 5 or more, and omission of adjuvant therapy were associated with decreased disease‐free survival (DFS). The addition of adjuvant chemotherapy was not associated with improved survival. Conclusion Patients with invasive nodal disease from HPV‐related oropharyngeal SCC can be managed with up‐front surgery and adjuvant therapy, as indicated with good regional control. Although distant recurrence was the primary site of failure, adjuvant chemotherapy was not associated with improved outcomes. The T classification, node number, and adjuvant radiotherapy are independent prognostic factors in this patient population.