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The relevance of the lymph node ratio as predictor of prognosis is higher in HPV ‐negative than in HPV ‐positive oropharyngeal squamous cell carcinoma
Author(s) -
Meyer M.F.,
Meinrath J.,
Seehawer J.,
Lechner A.,
Odenthal M.,
Quaas A.,
Semrau R.,
Huebbers C.U.,
Marnitz S.,
Büttner R.,
Beutner D.
Publication year - 2018
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.12938
Subject(s) - medicine , oncology , lymph node , univariate analysis , multivariate analysis , human papilloma virus , carcinoma , clinical significance , retrospective cohort study , cancer , cervical cancer
Objectives Lymph node ratio ( LNR ) is an established predictor in different entities of carcinoma, including head and neck malignancies. In oropharyngeal squamous cell carcinoma ( OPSCC ), lymph node involvement differs between human papilloma virus ( HPV )‐positive and HPV ‐negative tumours. Herein, we evaluate the impact of HPV association on the concept of LNR . Methods 88 surgically treated patients were included in this retrospective chart review. HPV ‐positive and HPV ‐negative OPSCC were evaluated for prediction of outcome by LNR separately. The endpoints were 5‐year overall survival ( OS ) and recurrence‐free survival ( RFS ). Results The OS of all patients was 60.1%. In univariate analysis, LNR was a significant predictor of overall survival rate ( P =.008) in OPSCC independently of the HPV status, as well as extracapsular spread (ECS). T‐classification was only a significant predictor in the univariate analysis in HPV ‐positive OPSCC carcinoma. However, in the multivariate analysis LNR remained predictor of prognosis in all OPSCC and in HPV ‐negative OPSCC . In patients with HPV ‐positive OPSCC , only T‐classification reached significance to predict OS . Conclusion Prognosis of primarily operated HPV ‐positive patients might be more dependent on the extent of primary tumour site, whereas prognosis of HPV ‐negative patients is based more on cervical metastatic spread, represented by LNR .