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Low‐risk human papilloma virus positive oropharyngeal cancer with one positive lymph node: Equivalent outcomes in patients treated with surgery and radiation therapy versus surgery alone
Author(s) -
Sample Reilly A.,
Wood Carey Burton,
Mazul Angela L.,
Barrett Thomas F.,
Paniello Randal C.,
Rich Jason T.,
Kang Stephen Y.,
Zevallos Jose,
Daly Mackenzie D.,
Thorstad Wade L.,
Chen Stephanie Y.,
Pipkorn Patrik,
Jackson Ryan S.,
Puram Sidharth V.
Publication year - 2021
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.26642
Subject(s) - medicine , hazard ratio , lymph node , radiation therapy , oncology , human papilloma virus , cancer , randomized controlled trial , proportional hazards model , surgery , confounding , cervical cancer , confidence interval
Background For human papilloma virus positive (HPV+) oropharyngeal squamous cell carcinoma (OPSCC), management recommendations for patients with a single metastatic lymph node <6 cm in diameter remain nebulous, leading to treatment heterogeneity in this common subgroup of patients. Methods We utilized the National Cancer Database to perform survival and multivariable analyses of patients with HPV+ OPSCC with one positive lymph node <6 cm and negative surgical margins. Results We found that 5‐year survival is comparable between patients who receive surgery and adjuvant radiation versus surgery alone. In multivariable analyses, we found no significant difference in the hazard ratio of overall survival after adjusting for various potential confounders. Conclusions These data suggest that patients with margin‐negative HPV+ OPSCC with a single positive lymph node <6 cm have comparable survival with or without adjuvant radiation. Future studies exploring outcomes for this specific group in randomized‐controlled trials will be critical for further evaluating these initial observations.