The relevance of the lymph node ratio as predictor of prognosis is higher in HPV‐negative than in HPV‐positive oropharyngeal squamous cell carcinoma

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 e...

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Published in:Clinical otolaryngology 2018-02, Vol.43 (1), p.192-198
Main Authors: Meyer, M.F., Meinrath, J., Seehawer, J., Lechner, A., Odenthal, M., Quaas, A., Semrau, R., Huebbers, C.U., Marnitz, S., Büttner, R., Beutner, D.
Format: Article
Language:English
Subjects:
cancer
Classification
Head
Human papillomavirus
Lymph
lymph node density
lymph node ratio
Lymph nodes
Lymphatic system
Medical prognosis
Metastases
Multivariate analysis
Neck
oropharyngeal squamous carcinoma
overall survival
Patients
Prognosis
recurrence‐free survival
Squamous cell carcinoma
Survival
Throat cancer
Tumors
Viruses
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Summary: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.
ISSN:1749-4478
1749-4486
DOI:10.1111/coa.12938