Prognostic significance of extra-nodal extension and positive surgical margins in HPV positive oropharyngeal squamous cell carcinoma

• Published in: American journal of otolaryngology 2023-07, Vol.44 (4), p.103877-103877, Article 103877
• Main Authors: Kaur, Varinder, Rooney, Anthony, Horton, Bethany J.
• Format: Article
• Language: English
• Subjects: Carcinoma, Squamous Cell - pathology; Extra-capsular extension; Extra-nodal extension; Head and Neck Neoplasms - pathology; Head neck cancer; HPV positive; Humans; Margins of Excision; Neoplasm Staging; Oropharyngeal Neoplasms - pathology; Papillomavirus Infections; Prognosis; Retrospective Studies; Squamous Cell Carcinoma of Head and Neck - pathology; Surgical margin status
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2023.103877

Whether extra-nodal extension (ENE+) and surgical margin positivity (margin+) are poor prognostic factors in HPV-associated (HPV+) oropharyngeal carcinoma (OPC) remains uncertain. Our study evaluated if microscopic ENE+ and/or margin+ are associated poorer recurrence free survival (RFS) and overall survival (OS) in HPV+ OPC. Patients were classified as high risk (ENE+ and/or margin+) or low risk (ENE- and margins-). Of a total of 176 patients HPV+ OPC, 81 underwent primary surgery and dad data on ENE and margin status. There was no statistically significant difference in RFS (p = 0.35) or OS (p = 0.13) for high-risk versus low-risk groups. Ongoing smoking (p = 0.023), alcohol use (p = 0.044) and advanced stage (p = 0.019) were associated with higher risk of recurrence. Only advanced stage (p-value