Premium
The prognostic impact of level I lymph node involvement in oropharyngeal squamous cell carcinoma
Author(s) -
Xiao Roy,
Ward Matthew C.,
Yang Kailin,
Adelstein David J.,
Koyfman Shlomo A.,
Prendes Brandon L.,
Burkey Brian B.
Publication year - 2019
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.25927
Subject(s) - medicine , oncology , lymph node , cancer , cohort , odds ratio , carcinoma , overall survival
Background We investigated the impact of level I lymph node involvement (LNI) on survival for patients with oropharyngeal squamous cell carcinoma (OPSCC). Methods We performed a cohort study of patients with OPSCC who underwent resection with known human papillomavirus (HPV) status in the National Cancer Database (2010‐2014). Results Among 5591 patients with OPSCC, 599 (10.7%) had level I LNI. Predictors of level I LNI included pT classification (pT3 vs pT1; odds ratio [OR], 1.95; P < 0.001), pN classification (pN3 vs pN1; OR, 1.63; P = 0.05), and level III LNI (OR, 6.05; P < 0.001). Among included patients, 4035 had known survival status. Level I LNI predicted inferior overall survival (OS) while adjusting for covariates (HR, 1.64; P < 0.001). Subset analyses revealed association between level I LNI and inferior OS among patients with base of tongue cancer, pT/pN classification greater than 1, and HPV‐negative cancer. Conclusions Level I LNI predicts inferior OS, particular among patients with at least pT2 or pN2 OPSCC.